Adjuvant therapy in women with early stage uterine serous carcinoma: A multi-institutional study

Kurnit, Katherine C.; Nobre, Silvana Pedra; Fellman, Bryan M.; Iglesias, David A.; Lindemann, Kristina; Jhingran, Anuja; Eriksson, Ane Gerda Z.; Ataseven, Beyhan; Glaser, Gretchen E.; Müller, Jennifer J.; Westin, Shannon N. und Soliman, Pamela T. (2022): Adjuvant therapy in women with early stage uterine serous carcinoma: A multi-institutional study. In: Gynecologic Oncology, Bd. 167, Nr. 3: S. 452-457

Abstract

Objective. Uterine serous carcinoma is a rare but aggressive subtype of endometrial adenocarcinoma. Our objective was to compare adjuvant treatment strategies for patients with early stage uterine serous carcinoma. Methods. This multi-institutional, retrospective cohort study evaluated patients with early stage uterine serous carcinoma. Patients with FIGO Stage IA-II disease after surgery, whose tumors had serous or any mixed serous/non-serous histology were included. Patients with carcinosarcoma were excluded. Clinical data were abstracted fromlocalmedical records. Summary statistics, Fisher's exact, and Kruskal-Wallis tests were used to analyze demographic and clinical characteristics. Univariable and multivariable analyses were performed for recurrence-free and overall survival. Results. There were 737 patients included. Most patients had Stage IA disease (75%), 49% of which had no myometrial invasion. Only 164 (24%) tumors had lymphatic/vascular space invasion. Adjuvant treatment varied: 22% received no adjuvant therapy, 17% had chemotherapy alone, 19% had cuff brachytherapy, 35% had cuff brachytherapywith chemotherapy, and 6% underwent pelvic radiation. Adjuvant treatmentwas significantly associated with a decreased risk of recurrence (p = 0.04). Compared with no adjuvant therapy, patients who received brachytherapy or brachytherapy/chemotherapy had improved recurrence-free survival (HR 0.59, 95% CI 0.40-0.86;HR 0.65, 95% CI 0.49-0.88, respectively) and overall survival (HR 0.53, 95% CI 0.35-0.79;HR 0.49, 95% CI 0.35-0.69, respectively). Improved survival with brachytherapy and brachytherapy/chemotherapy persisted on multivariable analyses. Chemotherapy alone was also associated with improved overall survival compared with no adjuvant treatment (HR 0.55, 95% CI 0.37-0.81). Conclusions. Adjuvant therapy was associated with a decreased risk of recurrence relative to observation alone. Adjuvant cuff brachytherapywith andwithout chemotherapywas associated with improved survival outcomes in patients with early stage uterine serous carcinoma.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0090-8258
• Sprache: Englisch