Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

Nasioudis, Dimitrios; Roy, A.G.; Ko, Emily; Cory, Lori; Giuntoli, Robert L.; Haggerty, Ashley; Kim, Sarah H.; Morgan, Mark A.; Latif, Nawar

doi:10.1136/ijgc-2020-001379

Cited by 18 publications

(9 citation statements)

References 18 publications

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“…Recent data from PORTEC-3 study proved the survival benefit of chemotherapy addition in uterine serous carcinomas [ 12 , 40 ]. Similar results were obtained from the retrospective study of Nasioudis et al for early-stage USC [ 41 ]. Additionally, our findings accentuate the diversity of treatments and their combination used in the adjuvant setting in this patients’ cohort, which are consistent with previous studies in other countries [ 42 , 43 ] and reflect the corresponding treatment options suggested by international guidelines [ 35 ].…”

Section: Discussionsupporting

confidence: 89%

What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience

et al. 2021

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Uterine serous carcinoma accounts for 3–10% of endometrial cancers, but it is the most lethal histopathological subtype. The molecular characterization of endometrial carcinomas has allowed novel therapeutic approaches for these patients. We undertook a retrospective analysis of patients with uterine serous carcinomas treated in our hospital within the last two decades to identify possible changes in their management. The patients and their characteristics were evenly distributed across the two decades. Treatment modalities did not change significantly throughout this period. After adjuvant treatment, patients’ median disease-free survival was 42.07 months (95% CI: 20.28–63.85), and it did not differ significantly between the two decades (p = 0.059). The median overall survival was 47.51 months (95% Cl: 32.18–62.83), and it significantly favored the first decade’s patients (p = 0.024). In patients with de novo metastatic or recurrent disease, median progression-free survival was 7.8 months (95% Cl: 5.81–9.93), whereas both the median progression-free survival and the median overall survival of these patients did not show any significant improvement during the examined time period. Overall, the results of our study explore the minor changes in respect of uterine serous carcinoma’s treatment over the last two decades, which are reflected in the survival outcomes of these patients and consequently underline the critical need for therapeutic advances in the near future.

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Section: Discussionsupporting

confidence: 89%

What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience

et al. 2021

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“…Also, more patients in the observation group had government insurance (compared with private insurance) which could explain the difference in overall survival. 10 With regards to lymph node staging, a recent expert review has concluded that SLN evaluation is adequate for the staging of Original research uterine serous carcinoma. Indeed, the review confirms that accumulating data support the safety and effectiveness of SLN mapping for apparent early-stage uterine serous carcinoma.…”

Section: Results In the Context Of Published Literaturementioning

confidence: 99%

“…7 There have been a few retrospective studies with a limited number of patients studying those precise cases. [8][9][10][11][12][13][14][15][16][17] At our center, most patients do not receive adjuvant treatment after surgery.…”

Section: Original Researchmentioning

confidence: 99%

High-grade endometrial carcinoma limited to the endometrium or a polyp: is adjuvant treatment necessary?

Nantel

Renaud

Grégoire

et al. 2021

Int J Gynecol Cancer

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ObjectiveHigh-grade endometrial carcinoma limited to the endometrium or a polyp is a rare clinical entity. Currently there is no consensus on standard treatment. Thus, the goal of this study was to evaluate the clinical outcomes of patients with type II endometrial carcinoma without myometrial infiltration or limited to a polyp.MethodsWe retrospectively identified type II endometrial carcinoma (FIGO endometrioid grade 3, serous, clear cell, mixed and carcinosarcoma) with spread limited to the endometrium or a polyp from April 2013 to November 2017. Medical records were reviewed for the following information: age at diagnosis, patient characteristics, type of surgery, histology, stage according to FIGO 2009 classification, adjuvant treatments, and site of recurrence. Descriptive statistics and the Kaplan–Meier estimate were used for analysis.ResultsA total of 25 patients with a type II stage IA adenocarcinoma were included. All were surgically staged with total hysterectomy, salpingo-oophorectomy, and lymph nodes assessment. The median age at diagnosis was 69 years. All patients had either disease limited to the endometrium (60%) or a polyp (40%). Only four patients had lymphovascular space invasion (16%). The median follow-up was 44 (range 2–67) months. Six patients (24%) received vault brachytherapy only and all others received no adjuvant treatment after surgery (n=19, 76%). Three patients (12%) experienced recurrences at 15, 21, and 55 months after surgery. Following systemic treatment all are alive and disease-free. The 3-year progression-free survival and overall survival were 91% and 100%, respectively.ConclusionExpectant management with surveillance alone following surgery appears to be safe for patients with high-grade endometrial carcinoma limited to a polyp or the endometrium without myometrial invasion.

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“…There is a paucity of data on adjuvant treatment for stage IA serous and clear cell carcinoma without myometrial invasion and/or occurring in a polyp. In a recent retrospective analysis from the National Cancer Database on 1709 patients with serous carcinoma confined to the myometrium, 5-year OS was 82% for those who had no adjuvant therapy, 85% for those who received adjuvant radiotherapy, and 91% for those who received adjuvant chemoradiation or chemotherapy alone [40]. We do not yet have sufficient data to uniformly recommend chemotherapy for stage I noninvasive serous endometrial carcinoma.…”

Section: Adjuvant Therapy and The Role Of Sentinel Lymph Node Mappingmentioning

confidence: 89%

Advances in management of nonendometrioid endometrial carcinoma, with an emphasis on the sentinel lymph node technique

Eriksson

Mueller

2021

Current Opinion in Oncology

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Purpose of reviewDuring the last few years there have been important advances in our understanding of endometrial cancer biology, staging, and therapy. In this article, we discuss updates and controversies in the treatment of nonendometrioid endometrial carcinoma (non-EEC), with an emphasis on the role of sentinel lymph node (SLN) biopsy. Recent findingsLymph node involvement is an important factor in determining prognosis and guiding adjuvant therapy in endometrial carcinoma. SLN biopsy has emerged as a less morbid alternative to lymphadenectomy in surgical staging, and it has generally gained acceptance in the setting of low-grade endometrial carcinoma; however, its role in the setting of high-grade disease remains a topic of debate. Several prospective studies have demonstrated the accuracy of SLN biopsy in detecting nodal metastasis in highgrade endometrial carcinoma. Retrospective series have compared oncologic outcomes of patients with high-grade disease, surgically staged by SLN biopsy, to those staged with lymphadenectomy, and have reported similar survival outcomes. Prospective data on survival is lacking. SummaryCurrently, there is sufficient data to support the diagnostic accuracy of SLN biopsy in the surgical staging of non-EEC. The retrospective evidence demonstrates similar survival for SLN biopsy versus lymphadenectomy.

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Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

Cited by 18 publications

References 18 publications

What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience

What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience

High-grade endometrial carcinoma limited to the endometrium or a polyp: is adjuvant treatment necessary?

Advances in management of nonendometrioid endometrial carcinoma, with an emphasis on the sentinel lymph node technique

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