Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

2020 ◽  
Vol 159 ◽  
pp. 230-231
Author(s):  
D. Nasioudis ◽  
A.G. Roy ◽  
E.M. Ko ◽  
R.L. Giuntoli ◽  
A.F. Haggerty ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Figo Stage ◽  
Stage I ◽  
Serous Carcinoma ◽  
Uterine Serous Carcinoma

scholarly journals Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

2020 ◽  
Vol 30 (8) ◽  
pp. 1089-1094 ◽  
Author(s):  
Dimitrios Nasioudis ◽  
Allison Grace Roy ◽  
Emily M Ko ◽  
Lori Cory ◽  
Robert L Giuntoli II ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Myometrial Invasion ◽  
Stage I ◽  
Serous Carcinoma ◽  
Rank Test ◽  
Survival Difference ◽  
Uterine Serous Carcinoma ◽  
The Impact

ObjectivesThe role of adjuvant treatment for early-stage uterine serous carcinoma is not defined. The goal of this study was to investigate the impact of adjuvant treatment on survival of patients with tumors confined to the endometrium.MethodsPatients diagnosed with stage I uterine serous carcinoma with no myometrial invasion between January 2004 and December 2015 who underwent hysterectomy with at least 10 lymph nodes removed were identified from the National Cancer Database. Adjuvant treatment patterns defined as receipt of chemotherapy and/or radiotherapy within 6 months from surgery were investigated and overall survival was evaluated using Kaplan–Meier curves, and compared with the log-rank test for patients with at least one month of follow-up. A Cox analysis was performed to control for confounders.ResultsA total of 1709 patients were identified; 833 (48.7%) did not receive adjuvant treatment, 348 (20.4%) received both chemotherapy and radiotherapy, 353 (20.7%) received chemotherapy only, and 175 (10.2%) received radiotherapy only. Five-year overall survival rates for patients who did not receive adjuvant treatment (n=736) was 81.9%, compared with 91.3% for those who had chemoradiation (n=293), 85.1% for those who received radiotherapy only (n=143), and 91.0% for those who received chemotherapy only (n=298) (p<0.001). After controlling for age, insurance status, type of treatment facility, tumor size, co-morbidities, and history of another tumor, patients who received adjuvant chemotherapy (HR 0.64, 95% CI 0.42, 0.96), or chemoradiation (HR 0.55, 95% CI 0.35, 0.88) had better survival compared with those who did not receive any adjuvant treatment, while there was no benefit from radiotherapy alone (HR 0.85, 95% CI 0.53, 1.37). There was no survival difference between chemoradiation and chemotherapy only (HR 1.15, 95% CI 0.65, 2.01).ConclusionAdjuvant chemotherapy (with or without radiotherapy) is associated with a survival benefit for uterine serous carcinoma confined to the endometrium.

A comparison of adjuvant therapy approaches for patients with early-stage uterine serous carcinoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5517-5517
Author(s):  
Katherine Kurnit ◽  
Silvana Pedra Nobre ◽  
Bryan M. Fellman ◽  
David A Iglesias ◽  
Kristina Lindemann ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Serous Carcinoma ◽  
Stage Ia ◽  
Multivariable Analyses ◽  
Uterine Serous Carcinoma

5517 Background: Uterine serous carcinoma is a less common subtype of endometrial cancer that is associated with poorer survival. The optimal post-operative adjuvant treatment strategy for these patients remains uncertain. 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 mixed serous/non-serous histology were included. Patients with carcinosarcoma were excluded. Clinical data were abstracted from local medical 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 survival (RFS) and overall survival (OS). Results: 634 patients were included. 77% of patients had Stage IA disease, 42% showed no myometrial invasion. The majority had pure serous histology (72%) and LVSI (76%). Adjuvant treatment varied: 12% received no adjuvant therapy, 7% had chemotherapy alone, 51% had cuff brachytherapy, 12% had cuff brachytherapy with chemotherapy (cuff/chemo), and 19% underwent pelvic radiation (EBRT). Complete RFS and OS data were available for 607 and 609 patients, respectively, and the median follow-up time was 58 months. As compared with patients who received no adjuvant therapy, patients who received cuff or cuff/chemo had improved RFS (cuff: HR 0.70, p = 0.02; cuff/chemo HR 0.53, p = 0.01) and OS (cuff HR 0.56, p = 0.001; cuff/chemo HR 0.48, p = 0.01). In a direct comparison, patients with cuff/chemo had better RFS and OS than those with chemotherapy alone (RFS HR 0.52, p = 0.03; OS HR 0.50, p = 0.05). There were no differences in RFS or OS for women who received chemotherapy alone or EBRT. Improved survival with cuff and cuff/chemo persisted on multivariable analyses (included age, stage, LVSI, adjuvant therapy type); additionally, EBRT was also associated with improved OS. In analyses limited to patients without myometrial invasion, patients with cuff or cuff/chemo had improved RFS and OS compared with observation alone. Conclusions: The use of adjuvant cuff brachytherapy with and without chemotherapy was associated with improved RFS and OS in patients with early stage uterine serous carcinoma.

National patterns of adjuvant treatment for stage I uterine serous carcinoma: A SEER-Medicare analysis

2018 ◽  
Vol 149 ◽  
pp. 155-156
Author(s):  
A.F. Haggerty ◽  
S.A. Mastroyannis ◽  
A. Graul ◽  
C.M. Brensinger ◽  
R.L. Giuntoli ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Stage I ◽  
Serous Carcinoma ◽  
Uterine Serous Carcinoma

Outcomes of Patients With Uterine Serous Carcinoma Using the Revised FIGO Staging System

2012 ◽  
Vol 22 (3) ◽  
pp. 452-456 ◽  
Author(s):  
Shelly Seward ◽  
Rouba Ali-Fehmi ◽  
Adnan R. Munkarah ◽  
Assaad Semaan ◽  
Zaid R. Al-Wahab ◽  
...  
Keyword(s):  
Survival Rate ◽  
Adjuvant Therapy ◽  
Myometrial Invasion ◽  
Staging System ◽  
Figo Stage ◽  
Stage I ◽  
Serous Carcinoma ◽  
Angiolymphatic Invasion ◽  
Stage Ia ◽  
Uterine Serous Carcinoma

ObjectiveOur aim was to evaluate the prognostic significance of the revised 2009 International Federation of Gynecology and Obstetrics (FIGO) staging criteria in patients with uterine serous carcinoma (USC).Materials and MethodsWe retrieved clinical and histopathologic data on women with USC from 2 large academic centers. Age, race, stage, myometrial invasion, angiolymphatic invasion, and adjuvant therapy were analyzed using Kaplan-Meier and Cox regression models.ResultsA total of 168 patients were included. Three-year survival rate was 81% for revised stage I, 52% for stage II, 46% for stage III, and 19% for stage IV. Survival was not significantly different when comparing overall 1988 FIGO stage I or II to 2009 FIGO stage I or II. The 3-year survival rate for 1988 stage IA (93%), IB (75%), and IC (60%) significantly differed (P = 0.02). When patients were restaged using the 2009 staging system, the 3-year overall survival of 2009 stage IA dropped to 83.4% and 68.8% for stage IB. New FIGO stage, myometrial invasion, angiolymphatic invasion, and administration of chemotherapy all remained independent predictors of survival on multivariate analysis (P < 0.05). Of note, extrauterine disease was observed in 22% of patients without myometrial invasion. Age and race were not prognostic factors for either classification.ConclusionsThe streamlined 2009 FIGO criteria do not adequately delineate survival for USC in early-stage disease. The 1988 FIGO classification correctly identified 3 subgroups of stage I USC patients with significantly different survival that is lost with the elimination of the most favorable 1988 stage IA subgroup. Because evaluation for adjuvant therapy and patient planning may change based on survival information, further evaluation of more appropriate USC staging is warranted. Caution should be taken when evaluating therapeutic response and comparing studies using these revised criteria in the future.

Population-based treatment and outcomes of Stage I uterine serous carcinoma

2014 ◽  
Vol 132 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Louis J.M. van der Putten ◽  
Paul Hoskins ◽  
Anna Tinker ◽  
Peter Lim ◽  
Christina Aquino-Parsons ◽  
...  
Keyword(s):  
Population Based ◽  
Stage I ◽  
Serous Carcinoma ◽  
Uterine Serous Carcinoma

scholarly journals Clinical features of ProMisE groups identify different phenotypes of patients with endometrial cancer

2021 ◽  
Author(s):  
Antonio Raffone ◽  
Antonio Travaglino ◽  
Olimpia Gabrielli ◽  
Mariacarolina Micheli ◽  
Valeria Zuccalà ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Clinical Features ◽  
Adjuvant Treatment ◽  
Meta Analysis ◽  
Figo Stage ◽  
Stage I ◽  
Pooled Prevalence ◽  
Prognostic Groups

Abstract Background The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) groups has identified four molecular prognostic groups of endometrial cancer (EC): POLE-mutated (POLE-mt), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), p53-wild-type (p53-wt). These groups might have different pathogenesis and risk factors, and might occur in different phenotypes of patients. However, these data are still lacking. Objective To provide a clinical characterization of the ProMisE groups of EC. Methods A systematic review and meta-analysis was performed by searching seven electronic databases from their inception to December 2020, for all studies reporting clinical characteristics of EC patients in each ProMisE group. Pooled means of age and BMI and pooled prevalence of FIGO stage I and adjuvant treatment in each ProMisE group were calculated. Results Six studies with 1, 879 women were included in the systematic review. Pooled means (with standard error) and prevalence values were: in the MMR-d group, age = 66.5 ± 0.6; BMI = 30.6 ± 1.2; stage I = 72.6%; adjuvant treatment = 47.3%; in the POLE-mt group, age = 58.6 ± 2.7; BMI = 27.2 ± 0.9; stage I = 93.7%; adjuvant treatment = 53.6%; in the p53-wt group, age = 64.2 ± 1.9; BMI = 32.3 ± 1.4; stage I = 80.5%; adjuvant treatment = 45.3%; in the p53-abn group, age = 71.1 ± 0.5; BMI = 29.1 ± 0.5; stage I = 50.8%; adjuvant treatment = 64.4%. Conclusion The ProMisE groups identify different phenotypes of patients. The POLE-mt group included the youngest women, with the lower BMI and the highest prevalence of stage I. The p53-wt group included patients with the highest BMI. The p53-abn group included the oldest women, with the highest prevalence of adjuvant treatment and the lowest prevalence of stage I. The MMR-d group showed intermediate values among the ProMisE groups for all clinical features.

scholarly journals Ten-Year Results of Postoperative Adjuvant Treatment In Women With Stage I Endometrial Cancer

2021 ◽  
Author(s):  
Peiying Fu ◽  
Ting Zhou ◽  
Pengfei Cui ◽  
Shixuan Wang ◽  
Ronghua Liu
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Stage I ◽  
Rank Test ◽  
Adjuvant Therapies ◽  
Early Stage Endometrial Cancer ◽  
Postoperative Adjuvant Treatment

Abstract Background: It remains controversial whether postoperative adjuvant treatment is beneficial for the survival of patients after surgery for early-stage endometrial cancer. To evaluate whether postoperative adjuvant treatment is beneficial for the survival of patients after surgery for early-stage endometrial cancer. We analyzed the outcomes of patients treated with radiotherapy, chemotherapy, or progestagen combined with other adjuvant treatments. Methods: We retrospectively examined disease-free survival (DFS), overall survival (OS) and high risk factors that affected the survival status of all patients who received different postoperative adjuvant therapies. Results: The total relapse and mortality rates were 5.57% and 1.68%, respectively. During follow-up period, fourteen patients (7.29%) developed isolated local recurrence, and 2 patients died (1.04%) of recurrence. The 5-year DFS and OS rates in all patients were 95.83% and 93.75%, respectively. No significant differences were observed in the 5-year DFS, 5-year OS, OS, or DFS among the four groups of patients with FIGO stage I endometrial cancer. The differences in the log-rank test results of the estimates of the 5-year DFS, 5-year OS, DFS and OS of patients with different disease stages and different ages were all significant, but no differences were observed in these parameters between patients with varying degrees of differentiation. Histologic grade, CA125 level, ER and PR status and whether adjuvant therapies had no significant effect on the DFS and OS of all patients according to univariate and multivariate regression analyses, but age stratification did reveal significant differences in DFS and OS in the univariate and multivariate analyses. Conclusion: This retrospective study showed that adjuvant treatments after surgery were not significantly associated with improved DFS or OS in patients with early-stage endometrial cancer. However, FIGO stage and age affected the survival of patients with stage I endometrial cancer.

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