Prognostic Factors of Uterine Serous Carcinoma—A Multicenter Study

Zhong, Xu; Wang, Jianliu; Kaku, Tengen; Wang, Zhiqi; Li, Xiaoping; Wei, Lihui

doi:10.1097/igc.0000000000001272

Cited by 13 publications

(7 citation statements)

References 35 publications

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“…Overall, the 35% recurrence-rate we found in our cohort is well-comparable to what reported in previous studies [ 24 25 ]. In accordance with the most recent published literature, we found the presence of positive lymph node(s) at final histology the main adverse factor influencing both DFS and DSS [ 25 ], while the administration of chemotherapy and age were associated with poorer progression and survival outcomes, respectively. Moreover, the updated analysis of the PORTEC 3 [ 26 ], showed a significantly improved overall survival and failure-free survival with the use of chemotherapy in addition to radiotherapy especially in patients with USC.…”

Section: Discussionsupporting

confidence: 91%

Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Casarin

Bogani

Piovano³

et al. 2020

J Gynecol Oncol

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Objective Uterine serous carcinoma (USC) is a rare highly aggressive disease. In the present study, we aimed to investigate the survival implication of the systematic lymphadenectomy in patients who underwent surgery for apparent early-stage USC. Methods Consecutive patients with apparent early-stage USC surgically treated at six Italian referral cancer centers were analyzed. A comparison was made between patients who underwent retroperitoneal staging including at least pelvic lymphadenectomy “LND” vs. those who underwent hysterectomy alone “NO-LND”. Baseline, surgical and oncological outcomes were analyzed. Kaplan- Meier curves were calculated for disease-free survival (DFS) and disease-specific survival (DSS). Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). Results One hundred forty patients were analyzed, 106 LND and 34 NO-LND. NO-LND group (compared to LND group) included older patients (median age, 73 vs.67 years) and with higher comorbidities (median Charlson Comorbidity Index, 6 vs. 5) (p<0.001). No differences in terms of recurrence rate (LND vs. NO-LND, 33.1% vs. 41.4%; p=0.240) were observed. At Cox regression analysis lymphadenectomy did not significantly influence DFS (HR=0.59; 95% confidence interval [CI]=0.32–1.08; p=0.09), and DSS (HR=0.14; 95% CI=0.02–1.21; multivariable analysis p=0.07). Positive node was independently associated with worse DFS (HR=6.22; 95% CI=3.08–12.60; p<0.001) and DSS (HR=5.51; 95% CI=2.31–13.10; p<0.001), while adjuvant chemotherapy was associated with improved DFS (HR=0.38; 95% CI=0.17–0.86; p=0.02) and age was independently associated with worse DSS (HR=1.07; 95% CI=1.02–1.13; p<0.001). Conclusions Although lymphadenectomy did not show survival benefits in patients who underwent surgery for apparent early-stage USC, the presence of lymph node metastasis was the main adverse prognostic factors, supporting the prognostic role of the retroperitoneal staging also in this histological subtype.

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Section: Discussionsupporting

confidence: 91%

Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Casarin

Bogani

Piovano³

et al. 2020

J Gynecol Oncol

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“…LVSI is an established prognostic factor in EC and should be accounted for as a possible confounding variable when evaluating other prognostic factors, such as the stage and impact of positive cytology. As such, a large multi-institutional report by Zhong et al evaluated the impact of cytology status on USC and also failed to account for LVSI; and also neglected to include the impact of any type of treatment in multivariate analysis ( Zhong et al, 2018 ). The study performed by Seagle et al also evaluated early stage EC of multiple histologies and found positive cytology was associated with decreased overall survival, even in low-grade EC, and that adjuvant chemotherapy was associated with increased survival ( Seagle et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of positive cytology in uterine serous carcinoma: A reassessment

Corey

Fucinari

Elshaikh

et al. 2021

Gynecologic Oncology Reports

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“…In logistic regression analysis, only optimality was an independent significant factor for recurrence. In a multicenter uterine serous cancer study reported by Zhong et al, advanced stage, myometrial invasion, adnexal involvement, lymph node metastasis, and positive peritoneal cytology were stated as independently associated prognostic factors for the DFS, and these listed factors were also associated with disease recurrence (22) . However, in a single institution study of 62 uterine serous carcinoma cases it was found that positive peritoneal cytology, positive LVSI, positive lymph nodes, and adjuvant therapies were not statistically significant in survival analyses (23) .…”

Section: Discussionmentioning

confidence: 92%

The prognostic factors of survival and recurrence in patients with serous ovarian and uterine cancers treated in a single institution for 17 years

Demirtaş¹,

Gökçü²

2021

Curr Gynecol Oncol

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Objective: In this study, we aimed to identify the prognostic factors of survival and recurrence in ovarian and uterine serous cancer patients. Materials and methods: This was a retrospective study conducted at Tepecik Research and Education Hospital, İzmir, Turkey, between January 2002 and January 2019. The medical files of 2,027 endometrial and 821 ovarian patients who underwent examination for endometrial cancer and epithelial ovarian cancer were examined retrospectively by the same author. The data of eligible 385 and 49 patients diagnosed with ovarian and uterine serous carcinoma, respectively, were identified for analysis from the hospital database. Descriptive, univariate, and multivariate Cox regression and binary logistic regression analyses of patients were performed. Results: The mean age of ovarian serous cancer patients (n = 385) was 53.9 ± 10.9 years. The mean age of uterine serous cancer patients (n = 49) was 67.2 ± 10.6 years. A total of 81 ovarian serous cancer patients (21.0%) had stage 1, while 24 (6.2%) had stage 2, and 31 (8.1%) had stage 4 disease. A total of 26 uterine serous carcinoma patients (53.1%) had stage 1 disease, 6 (12.2%) had stage 2, 10 (20.4%) had stage 3, and 7 (14.3%) had stage 4 disease. For ovarian serous patients, stage, grade, optimality, neoadjuvant chemotherapy, adjuvant chemotherapy cycle number, and recurrence had impact on both overall and disease-free survival (p < 0.05). For uterine serous cancer patients, optimality was the only prognostic factor for both survival and recurrence (p = 0.01 and p = 0.01, respectively). Conclusion: In ovarian serous cancer patients, we found that disease stage, grade, optimality, neoadjuvant chemotherapy, and adjuvant chemotherapy cycle number had impact on overall and disease-free survival in both univariate and multivariate Cox regression analysis, whereas disease stage and optimality were the only significant prognostic factors for recurrence in ovarian serous cancer patients. However, in patients with uterine serous carcinomas, optimal surgery was the only independent prognostic factor both for survival and recurrence.

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Prognostic Factors of Uterine Serous Carcinoma—A Multicenter Study

Abstract: Peritoneal cytology and myometrial invasion could be independent prognostic factors for 3-year DFSR, cumulative recurrence, and cumulative mortality of patients with USC. Prospective studies are needed to confirm these results.

Cited by 13 publications

References 35 publications

Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Impact of positive cytology in uterine serous carcinoma: A reassessment

The prognostic factors of survival and recurrence in patients with serous ovarian and uterine cancers treated in a single institution for 17 years

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