Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women

  • Fraukje Pol Radboud University Medical Center
  • David Allen Mercy Hospital for Women
  • Ruud Bekkers Radboud University Medical Center
  • Peter Grant Mercy Hospital for Women
  • Simon Hyde Mercy Hospital for Women
Keywords: USC, endometrial cancer, adjuvant treatment, recurrence rates, survival rates

Abstract

Objectives: 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.

Author Biographies

Fraukje Pol, Radboud University Medical Center
MD Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen The Netherlands
David Allen, Mercy Hospital for Women
FRANZCOG, CGO, PhD Department of Gynaecological Oncology Mercy Hospital for Women Heidelberg Melbourne Australia
Ruud Bekkers, Radboud University Medical Center
MD, PhD Department of Obstetrics and Gynaecology Radboud University Medical Center Nijmegen The Netherlands
Peter Grant, Mercy Hospital for Women
FRANZCOG, CGO Department of Gynaecological Oncology Mercy Hospital for Women Heidelberg Melbourne Australia
Simon Hyde, Mercy Hospital for Women
FRANZCOG, CGO Department of Gynaecological Oncology Mercy Hospital for Women Heidelberg Melbourne Australia
Published
2015-03-11
Section
Original Research