title: Outcome of recurrent uterine papillary serous carcinoma treated with platinum-based chemotherapy.
abstract: OBJECTIVE
  The aim of this study was to estimate the outcome and response to platinum-based chemotherapy (CT) in patients with recurrent uterine papillary serous carcinoma (UPSC).
  
  
  METHODS
  Patients with recurrent UPSC from 2000 to 2012 were included retrospectively. All patients received platinum-based CT for recurrent disease. Platinum-free interval was divided into less than 6 months (platinum resistant) and 6 months or longer (platinum sensitive).
  
  
  RESULTS
  Twenty-two patients with recurrent UPSC were included. The median age was 66.5 years. The majority of the patients initially presented with advanced-stage disease (68%). A total of 84% (18/22) received adjuvant CT; all regimens were platinum based.The overall response rate (RR) and stable disease were 50% and 36.4%. The mean duration of response and stable disease were 9.4 and 5.6 months. Among the platinum-sensitive group, the overall RR was 64.7% compared with 0% in the platinum-resistant group. Among the patients who received prior adjuvant platinum-based CT, the RR was 38.8% compared with 100% among those who did not receive adjuvant CT. When stratified by platinum-based regimen, those who received the platinum-taxane regimen had a higher RR compared with those who received the platinum-gemcitabine regimen (62.5% vs 20%) among those who received prior adjuvant platinum therapy. The median progression-free survival and overall survival for the entire cohort were 8.4 and 24.9 months, respectively. The median progression-free survival was significantly longer for platinum-sensitive disease compared with platinum-resistant disease (10.2 vs 3.3 months, respectively; P = 0.002). Similarly, the median overall survival was longer for platinum-sensitive disease compared with platinum-resistant disease (27.1 vs 13.7 months, respectively). However, this difference was not statistically significant (P = 0.15).
  
  
  CONCLUSIONS
  Platinum-based CT is an active regimen in recurrent UPSC even if patients received prior adjuvant platinum CT. Platinum-free interval predicts response and outcome of platinum-based CT in recurrent setting such as in ovarian cancer. Plantinum-taxane is more active than platinum-gemcitabine in recurrent UPSC.
authors.affiliation: Gynecologic Oncology Division, Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Haider
authors.initials: H
authors.lastname: Mahdi
authors.forename: Anthony
authors.initials: A
authors.lastname: Rizzo
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D002291:Carcinoma, Papillary / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy*; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D000068258:Bevacizumab; D016190:Carboplatin; D017239:Paclitaxel; D000093542:Gemcitabine