title: Early stage uterine serous carcinoma: management updates and genomic advances.
abstract: OBJECTIVE
  Even in cases of early stage disease, uterine serous carcinoma (USC) is associated with high recurrence rates and a disproportionate number of cancer-related deaths. Prospective data to guide therapy for women with this disease are limited. This article reviews the currently available literature regarding optimal management of women with early stage USC.
  
  
  METHODS
  MEDLINE was searched for all research articles published in the English language from January 1, 1996 through October 30, 2012 in which the studied population included women diagnosed with early stage USC. Although preference was given to prospective studies, studies were not limited by design or numbers of patients in light of the relative paucity of the available literature.
  
  
  RESULTS
  Early stage USC (Stages I-II) is associated with a risk of recurrence that ranges from 0 to 80%, and is related to the amount of residual uterine disease, cervical involvement and adjuvant therapy. Treatment with platinum and taxane-based chemotherapy may decrease the risk of recurrence and may improve survival outcomes; volume directed radiotherapy may also be of benefit. USC highly expresses HER2/neu, a promising and rational target for biologic therapy. Alterations in the PIK3CA/AKT/ mTOR pathway are also of relevance and offer other potential therapeutic targets.
  
  
  CONCLUSIONS
  USC is a unique and biologically aggressive subtype of endometrial cancer, and as such, should be studied as a distinct entity. Prospective trials incorporating traditional chemotherapeutics and radiation as well as targeted therapies are warranted to define the optimal management approach for women with this disease.
authors: Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Amanda Nickles
authors: AN
authors: Fader
authors: Alessandro D
authors: AD
authors: Santin
authors: Paola A
authors: PA
authors: Gehrig
mesh_terms: D058534:Class I Phosphatidylinositol 3-Kinases; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D019869:Phosphatidylinositol 3-Kinases / Q000502:physiology; D051057:Proto-Oncogene Proteins c-akt / Q000502:physiology; D015398:Signal Transduction; D058570:TOR Serine-Threonine Kinases / Q000502:physiology; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*
chemical_list: D058534:Class I Phosphatidylinositol 3-Kinases; D019869:Phosphatidylinositol 3-Kinases; D051057:Proto-Oncogene Proteins c-akt; D058570:TOR Serine-Threonine Kinases; C546842:MTOR protein, human; C484760:PIK3CA protein, human