The Role of Cytoreductive Surgery in the Management of Stage IV Uterine Papillary Serous Carcinoma

Bristow, Robert E.; Duska, Linda R.; Montz, F.J.

doi:10.1006/gyno.2000.6110

Cited by 94 publications

(76 citation statements)

References 39 publications

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“…In studies depicted in Table 4, minor postoperative complications (wound infection, prolonged time to bowel movement, urinary tract infection, pneumonia and deep venous thrombosis) after primary debulking occurred in 36 -39% of the cases. Major life-threatening complications (small bowel obstruction, myocardial infarction and pulmonary embolism) occurred in 13% of cases (Bristow et al, 2001;Memarzadeh et al, 2002). These data contrast to the current analysis in which minor and major postoperative complications were observed in 13 and 4% of cases, respectively.…”

Section: Discussioncontrasting

confidence: 99%

“…The amount of residual disease after surgery for advanced endometrial cancer has an impact on median survival and progression-free interval (PFI) (Goff et al, 1994;Chi et al, 1997;Bristow et al, 2001;Memarzadeh et al, 2002;Lambrou et al, 2004;Thomas et al, 2007). These data correspond to findings in ovarian cancer.…”

supporting

confidence: 66%

“…These data correspond to findings in ovarian cancer. Primary debulking is, however, associated with a considerable rate of postoperative complications: 34 -53% in ovarian cancer (Morice et al, 2003;Hou et al, 2007) and 36 -39% in endometrial cancer (Bristow et al, 2001;Memarzadeh et al, 2002). Moreover, taking into consideration the age and co-morbidities of endometrial cancer patients, there is a need for better treatment options.…”

mentioning

confidence: 99%

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Neoadjuvant chemotherapy followed by interval debulking surgery in patients with serous endometrial cancer with transperitoneal spread (stage IV): a new preferred treatment?

et al. 2009

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BACKGROUND: To investigate the value of neoadjuvant chemotherapy (NACT), followed by interval debulking surgery (IDS), in endometrial cancer with transperitoneal spread (stage IV). METHODS: Patients with endometrial cancer with transperitoneal spread, as determined by laparoscopy ( ± pleural effusion), were treated with NACT. Efficacy was determined according to the Response Evaluation Criteria in Solid Tumors, residual tumour at IDS and histopathological assessment of tumour regression. RESULTS: A total of 30 patients (median age: 65 years; range:44 -81 years) received 3 -4 cycles of NACT (83% paclitaxel/carboplatin). Histopathological subtypes were as follows: serous (90%), clear cell (3%) and endometrioid (6%) carcinoma. Response according to RECIST was as follows: 2 (7%) complete remission, 20 (67%) partial remission, 6 (20%) stable disease and 2 (7%) progressive disease (PD). Patients with PD were not operated upon. A total of 24 patients (80%) had optimal cytoreduction (R p1 cm), of whom 22 (92%) were without residual tumour. Four patients were considered inoperable and were excluded from further analysis. The median progression-free survival and overall survival times were 13 and 23 months, respectively. Histopathological features of chemoresponse in both uterus and omentum were related to a better PFS (P ¼ 0.017, hazard ratio (HR) ¼ 0.785) and overall survival (P ¼ 0.014, HR ¼ 0.707). In particular, the absence of tumour infiltration and necrosis were associated with prognosis. CONCLUSION: The use of NACT resulted in a high rate (80%) of optimal IDS for the treatment of endometrial cancer with transperitoneal spread.

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Section: Discussioncontrasting

confidence: 99%

supporting

confidence: 66%

mentioning

confidence: 99%

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Neoadjuvant chemotherapy followed by interval debulking surgery in patients with serous endometrial cancer with transperitoneal spread (stage IV): a new preferred treatment?

et al. 2009

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“…Maximal surgical effort should be undertaken to remove all gross disease, if possible. In a retrospective analysis, women with optimal disease resection as defi ned by the largest residuum of 1 cm or less had an improved overall survival [30]. In addition, those who had no residual disease had an even greater improvement in overall survival.…”

Section: Surgerymentioning

confidence: 97%

Uterine papillary serous carcinoma: State of the state

Naumann

2008

Curr Oncol Rep

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Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer that is likely to present with deep myometrial invasion and lymph vascular involvement. By the time most affected women are diagnosed, the UPSC has spread outside the uterus. Because many reports include patients who are not completely staged, the risk of recurrence in stage I patients has likely been overestimated. Recently, several large series of well-staged patients have demonstrated that survival in stage I patients is similar to that of poorly differentiated endometrioid tumors. Because of the high risk of extrauterine spread, all patients with UPSC should have an extended surgical staging procedure, including lymphadenectomy and omentectomy. Chemotherapy with or without local or regional radiation is probably the most effective adjuvant therapy in both early and advanced disease. Because patients with stage I UPSC are still at significant risk of recurrence, adjuvant therapy is often recommended for all patients. It has been difficult to conduct prospective randomized trials for patients with UPSC because of the rare nature of these cancers.

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“…Multiple studies have documented an inverse correlation between survival and the volume of residual disease remaining after cyto reductive surgery in the setting of serous ovarian carcinoma [50][51][52]. A number of retrospective studies suggest that cytoreductive surgery confers a survival benefit in women with metastatic UPSC as well [49,[51][52][53][54][55]. In a report of 70 women with stage IIIc or IV UPSC by Thomas et al, optimal cytoreduction (defined as no gross residual disease of >1 cm in diameter) was achieved in 60% of women, with no visible residual disease achieved in 37% [55].…”

Section: Surgerymentioning

confidence: 99%

Updates on uterine papillary serous carcinoma

Fader

Boruta

Olawaiye

et al. 2009

Expert Review of Obstetrics & Gynecology

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Uterine papillary serous carcinoma (UPSC) is a biologically aggressive subtype of endometrial cancer. Although much less common than its endometrioid carcinoma counterpart, UPSC accounts for a disproportionate number of endometrial cancer-related recurrences and subsequent deaths. Women most often present with postmenopausal vaginal bleeding. In women diagnosed with metastatic disease, ascites, omental implants or a pelvic mass may be present. Local and distant recurrences occur frequently, with extrapelvic relapses being observed most commonly. Although few prospective trials exist, several retrospective series have demonstrated that optimal cytoreduction and adjuvant platinum/taxane-based chemotherapy with or without radiotherapy appears to improve survival. In addition, another approach to the management of UPSC may lie in targeted therapy. This article reviews the recent literature concerning the epidemiology, molecular pathogenesis and management of UPSC.

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The Role of Cytoreductive Surgery in the Management of Stage IV Uterine Papillary Serous Carcinoma

Cited by 94 publications

References 39 publications

Neoadjuvant chemotherapy followed by interval debulking surgery in patients with serous endometrial cancer with transperitoneal spread (stage IV): a new preferred treatment?

Neoadjuvant chemotherapy followed by interval debulking surgery in patients with serous endometrial cancer with transperitoneal spread (stage IV): a new preferred treatment?

Uterine papillary serous carcinoma: State of the state

Updates on uterine papillary serous carcinoma

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