The role of omentectomy in the surgical treatment of uterine serous carcinoma

ObjectivesUterine serous carcinoma (USC) represents a rare and aggressive histologic subtype of endometrial cancer, associated with a poor prognosis. This article critically reviews the literature pertinent to the epidemiology, pathology, molecular biology, diagnosis, management, and perspectives of patients with USC.MethodsAs one of a series of The Gynecologic Cancer InterGroup (GCIG) Rare Tumor Working Group in London, November 2013, we discussed about USC many times with various experts among international GCIG groups.ResultsBoth USC and approximately 25% of high-grade endometrioid tumors represent extensive copy number alterations, few DNA methylation changes, low estrogen and progesterone levels, and frequent P53mutations. Uterine serous carcinoma shares molecular characteristics with ovarian serous and basal-like breast carcinomas. In addition to optimal surgery, platinum- and taxane-based chemotherapy should be considered in the treatment of both early- and advanced-stage disease. The combination of radiation and chemotherapy appears to be associated with the highest survival rates. The role of radiation therapy in the management of this disease, with a high propensity for distant failures, remains elusive.ConclusionsUterine serous carcinoma is a unique and biologically aggressive subtype of endometrial cancer and should be studied as a distinct entity. Futures studies should identify the optimized chemotherapy and radiation regimens, sequence of therapy and schedule, and the role of targeted biologic therapy.

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Uterine Serous Carcinoma; Molecular Pathways and Role of Micrornas in Early Detection and Target Therapy

Journal of Gynecology and Womens Health ◽

10.19080/jgwh.2017.07.555710 ◽

2017 ◽

Vol 7 (2) ◽

Author(s):

Shiva Rezaei

Keyword(s):

Early Detection ◽

Target Therapy ◽

Serous Carcinoma ◽

Molecular Pathways ◽

Uterine Serous Carcinoma

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The role of omentectomy during the surgical staging of uterine serous carcinoma

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200303000-00019 ◽

2003 ◽

Vol 13 (2) ◽

pp. 212-215 ◽

Cited By ~ 4

Author(s):

P. A. Gehrig ◽

L. Van Le ◽

W. C. Fowler

Keyword(s):

Ovarian Cancer ◽

Surgical Procedures ◽

Surgical Staging ◽

Serous Carcinoma ◽

Exact Test ◽

Uterine Serous Carcinoma ◽

Stage Ivb ◽

Sensitivity Specificity ◽

Omental Metastasis

Uterine serous carcinoma (USC) has a propensity for extrauterine spread, and some suggest that this disease be staged as an ovarian cancer, and thus include omental sampling. However, given the primary organ involved, the staging recommendations do not include omental sampling. The aim of this study is to evaluate the role of omental sampling during the surgical staging of USC. We retrospectively identified cases of USC at our institution from January 1990 to June 2000 and abstracted surgical procedures, stage, and sites of metastasis. Fisher's exact test was used to calculate sensitivity, specificity, and positive and negative predictive value. We identified 65 women with USC, of which 52 underwent omental evaluation. Thirty four of the omentums were visually normal and benign on histologic review. Two were visually negative and histologically positive for metastatic serous carcinoma. The remaining 16 specimens were grossly involved with histologic confirmation of disease. The sensitivity of a visually negative omentum is 0.89 (P < 0.0001). Microscopic omental metastasis from USC is rare. When the omentum is involved, thereby upstaging the patient to stage IVB disease, the disease is generally diagnosed by gross visualization. We conclude that omental sampling does not need to be included in the routine surgical staging of USC.

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The role of lymphadenectomy in patients with stage III&IV uterine serous carcinoma: Results of multicentric Turkish study

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2021.102063 ◽

2021 ◽

Vol 50 (5) ◽

pp. 102063

Author(s):

Caner Cakir ◽

Fatih Kilic ◽

Cigdem Kilic ◽

Nedim Tokgozoglu ◽

Burak Ersak ◽

...

Keyword(s):

Stage Iii ◽

Serous Carcinoma ◽

Uterine Serous Carcinoma

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Tumor Recurrence Rate and Survival Outcomes of Uterine Serous Carcinoma after Surgical Treatment

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.10.11770 ◽

2020 ◽

Vol 103 (10) ◽

pp. 1083-1090

Keyword(s):

Overall Survival ◽

Surgical Treatment ◽

Recurrence Rate ◽

Early Stage ◽

Disease Recurrence ◽

Serous Carcinoma ◽

Recurrence Free Survival ◽

Free Survival ◽

Uterine Serous Carcinoma

Background: Uterine serous carcinoma is a rare histologic subtype of endometrial cancer. Oncologic outcomes for this disease are sparsely reported, and adjuvant therapy after surgery is considerably heterogeneous. Objective: To determine the 2-year recurrence rate, recurrence-free survival, overall survival, and associated factors among patients with uterine serous carcinoma after surgical treatment at Siriraj Hospital. Materials and Methods: One hundred thirty uterine serous carcinoma patients diagnosed between December 2007 and June 2015 were enrolled. Patients who did not undergo surgery as a primary treatment or not achieve clinically complete response were excluded. Pathological slides were reviewed. Data were retrieved from the medical records including gynecologic data, surgical and pathological results, post-operative treatment, response status, recurrence status, and follow-up data. The recurrence rate at two years was calculated. Recurrence-free survival and overall survival were analyzed, and various characteristics were used to determine associated treatment outcomes. Results: One hundred nine patients were analyzed, 50 in stage I, 15 in stage II, 38 in stage III, and six in stage IV. Median follow-up time was 23 months. At two years, the recurrence rate was 35.8%. Post-operative treatment was performed in 91.7%, and chemotherapy was the most common modality used. Eleven patients (16.9%) in early-stage and twenty-five patients (56.8%) in the advanced stage had disease recurrence. Thirty patients (83.3%) had disease recurrence intra-abdominal or multiple metastases. No patient in stage I that received adjuvant chemotherapy had relapsed disease. Two-year recurrence-free survival and 2-year overall survival were 71.2% and 83.4%, respectively. FIGO staging was the only factor associated with recurrence-free survival. Conclusion: Uterine serous carcinoma represents a rare disease with a high recurrence rate and poor prognosis. FIGO staging is related to recurrence-free survival. Adjuvant chemotherapy showed survival benefits in early-stage uterine serous carcinoma. Keywords: Uterine serous carcinoma, Adjuvant therapy, Recurrence, Survival

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