title: Optimal cytoreduction, depth of myometrial invasion, and age are independent prognostic factors for survival in women with uterine papillary serous and clear cell carcinomas.
abstract: OBJECTIVE
  The purpose of this study was to investigate the clinicopathological characteristics, treatment methods, and prognostic factors in women with uterine papillary serous carcinoma (UPSC) and uterine clear-cell carcinoma (UCCC).
  
  
  METHODS
  All patients who had undergone surgery for UPCS and UCCC between January 1995 and December 2012 were retrospectively reviewed. Patients with missing data, who did not undergo surgical staging and patients with mixed tumor histology were excluded. Multivariate regression models were used to identify the risk factors for overall survival (OS) and progression-free survival (PFS).
  
  
  RESULTS
  A total of 49 UPSC and 22 UCCC women were included. The majority of the patients were at stage I [IA, 22 (31%) and IB, 18 (25.4%)]. Stages II, III, and IV were identified in 9 (12.7%), 13 (18.3%), and 9 (12.7%) of cases, respectively. Optimal cytoreduction was achieved in 71.8% of cases. Recurrences occurred in 16 patients (22.5%). The 5-year OS rates were 67% for UPSC; 76% for UCCC; 68% for both histology, respectively. Multivariate analysis pointed out that age>67 years (odds ratio (OR): 3.85, p = 0.009 and OR: 3.35, p = 0.014), >50% myometrial invasion (MI) (OR: 2.87, p = 0.037 and OR: 2.46, p = 0.046) and optimal cytoreduction (OR: 3.26, p = 0.006 and OR: 2.77, p = 0.015) were the independent prognostic factors for both PFS and OS.
  
  
  CONCLUSIONS
  Our study demonstrated that optimal cytoreduction, >50% MI, and age >67 years are the most significant factors affecting survival in women with UPSC and UCCC.
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Ulas
authors.initials: U
authors.lastname: Solmaz
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Mat
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: atalayekin@hotmail.com.
authors.forename: Atalay
authors.initials: A
authors.lastname: Ekin
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Gezer
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Biler
authors.affiliation: Department of Obstetrics and Gynecology, Acibadem University School of Medicine, Istanbul, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Peker
authors.affiliation: Department of Pathology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Ayaz
authors.affiliation: Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sanci
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000367:Age Factors; D000368:Aged; D018284:Cystadenocarcinoma, Serous / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery
keywords: Age; Myometrial invasion; Optimal cytoreduction; Uterine clear-cell carcinoma; Uterine papillary serous carcinoma