Factors Affecting the Prognosis and Overall Survival in Patients with Uterine Papillary Serous Carcinoma

Abstract

Introduction: Uterine Papillary Serous Carcinoma (UPSC) is a prototype of Type II Endometrial Cancers (EC) and represents 5-10% of all EC. It is clinically aggressive and responsible for over 50% of relapses and deaths in EC patients. Aim: To investigate factors affecting the overall survival in patients with UPSC. Materials and Methods: Forty-three women treated for UPSC between January 2006 and October 2015 were analysed retrospectively. Subjects were included if histology revealed a minimum of 10% component of serous carcinoma. Patients who required neoadjuvant therapy were excluded. All women underwent surgical treatment with at least total hysterectomy and bilateral salpingo-oophorectomy. The effect of age, tumour size, myometrial invasion, presence of malignant peritoneal cytology, lymph node metastasis, presence of the tumour outside the uterus and in the upper abdomen on the survival were investigated. The Kaplan-Meier method was used for survival analysis. Univariate analysis was used to evaluate the importance of each parameter and log rank test was used for significance. Significant parameters were analysed by multivariate Cox regression. Results: Forty-three patients diagnosed and treated for UPSC were analysed. Out of them, 38 (88.4%) underwent surgical staging. Relapse and disease progression despite therapy was observed in 9 (20.9%) cases. The overall survival was estimated to be 46.5%. Conclusion: The present study demonstrated that myometrial invasion, lymphovascular space involvement, and presence of a tumour in the upper abdomen were statistically significant parameters affecting the overall survival in UPSC patients.

Keywords

• metastases
• papillary cell carcinoma
• retroperitoneal lymph node involvement
• type ii endometrium cancer