Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women
Keywords: USC, endometrial cancer, adjuvant treatment, recurrence rates, survival rates
AbstractObjectives: The aim of this study was to assess our department’s management of uterine serous carcinoma (USC) and to determine the correlation of the recurrence and survival rates of stage I-IV patients with different adjuvant treatment modalities. Design: A retrospective, single-institution, observational cohort study was performed. Subjects and setting: The study participants were women diagnosed with stage I-IV USC between 1996 and 2012 at the Mercy Hospital for Women, Heidelberg, Australia. Outcome measures: Outcomes measures were tumour recurrence rates, relapse-free survival and overall survival relating to the different adjuvant treatment modalities. Method: A retrospective, single-institution study on 62 women with stage I-IV USC diagnosed between 1996 and 2012 was performed. Results: Thirty patients had stage I, 5 stage II, 16 stage III and 11 stage IV, disease. Twenty patients received no adjuvant treatment, 19 patients adjuvant radiotherapy, 13 adjuvant chemotherapy and 10 adjuvant chemoradiation. Thirty-two (52%) patients experienced a recurrence and 32 patients were deceased, of whom 29 deaths were USC related. Recurrence risk correlated with stage (p-value 0.000). Early-stage (I and II) disease was associated with significant better relapse-free survival and overall survival than advanced-stage (III and IV) disease (p-value 0.000 and p-value 0.001, respectively). Adjuvant treatment significantly improved relapse-free survival and overall survival (p-value 0.008 and p-value 0.020, respectively), compared to no adjuvant treatment. Furthermore, a statistically significant improvement in relapse-free survival (p-value 0.035) and a trend towards better overall survival (p-value 0.064) was demonstrated with chemotherapy. Conclusion: USC has a high recurrence rate and overall prognosis is poor. The stage of disease seems to be the best predictor of prognosis. This study suggests that even patients with early-stage (I and II) disease, i.e. either pure or mixed USC, should receive adjuvant treatment, as all of these women have a significantly high risk of recurrence. Currently, radiotherapy and chemotherapy are the adjuvant therapies used for USC. Prospective studies may help to determine the most effective adjuvant therapies.
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