1. Uterine serous carcinoma is more aggressive than high-grade serous ovarian carcinoma: a retrospective study H. Nagano1, Y. Tachibana1, M. Kawakami1, M. Ueno1, Y. Morita1, M. Muraoka1, K. Takagi1, M. Fujibayashi2 1Obstetrics and Gynecology, 2Pathology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
INTRODUCTION
RESULTS
SUMMARY / CONCLUSION
Uterine serous carcinoma (USC) is an aggressive histologic subtype of endometrial cancer.
Although USC accounts for less than 10% of endometrial cancer, it represents up to % of endometrial cancer associated deaths[1,2].
Because of the rarity of the disease, standardized treatment protocols have been difficult to develop.
Given that histology of USC closely resemble that of high-grade serous ovarian cancer (HGSOC), treatment protocols including cytoreductive surgery followed by taxane/platinum-based chemotherapy have been used.
However, there is no definite data comparing directly the prognoses of USC and HGSOC, when treated similar therapeutic strategies.
rTable 1. Clinical Characteristicsf
Table 1.
Fourteen patients with USC and 23 with HGSOC were evaluated.
The prevalence of advanced stages, stages III or IV, was 62% in USC and 70% in HGSOC.
All patients underwent surgery.
All except three patients with USC received taxane/platinum-based chemotherapy.
No patient received adjuvant radiation therapy.
Despite several limitations, our results suggest that USCs are more resistant to taxane/platinum-based chemotherapy, more aggressive than HGSCs, and have worse prognoses even though treated with the same strategies including cytoreductive surgery, maintenance chemotherapy, or multidisciplinary second-line therapies .
Hence, an alternate treatment strategy is required for USC.
Several attempts to identify potential therapeutic targets of USC are ongoing[3,4].
HGSOC (n=23)
USC
(n=14)
Median age (range), yr
67 (38-76)
69.5 (59-94)
Stage
I-II
7 (30.4%)
5 (35.7%)
III
14 (60.9%) IV
2 (8.7%)
4 (28.6%)
Extra-pelvic disease
16 (69.6%)
6 (42.9%)
Surgery
optimal
20 (87.0%)
13 (92.9%)
suboptimal
3 (13.0%)
1 ( 7.1%)
Chemo
neoadjuvant
4 (17.4%)
adjuvant
23 (100%)
11 (78.6%)
maintenance
11 (47.8%)
OS for HGSC
Median follow-up length for censored cases were 36 mo. (range, 11–56 mo.) and 71 mo. (range, 33–95 mo.) with USC and HGSOC, respectively.
Median OS for HGSOC was not achieved. 3- year OS were 85.7% and 87.5% with stages I–II and III–IV, respectively (not significant). (Figure 1)
Median OS for USC were 46 and 38 mo. in stage I and stages III–IV, respectively (not significant). (Figure 1)
Figure 1. Overall Survival (Stage I-II vs III-IV)
HGSOC
USC
Ｉ，ＩＩ
ＩＩＩ，IV
3-year OS
stage I–II: 85.7%
stage III–IV: 87.5%
median OS
stage I–II: 46 mo.
stage III–IV: 38 mo.
p = 0.80
AIM
REFERENCES
The objective of this study was to compare the prognoses of USC and HGSOC.
Hendrickson M, Ross J, Eifel P, et al. Uterine papillary serous carcinoma: a highly malignant form of endometrial adenocarcinoma. Am J Surg Pathol Mar;6:
del Carmen MG, Birrer M, Schorge JO. Uterine papillary serous cancer: a review of the literature. Gynecol Oncol. 2012;127:
Jones NL, Xiu J, Reddy SK, et al. Identification of potential therapeutic targets by molecular profiling of 628 cases of uterine serous carcinoma. Gynecol Oncol. 2015;138:620-6.
Mahdi H, Xiu J, Reddy SK, et al. Alteration in PI3K/mTOR, MAPK pathways and Her2 expression/amplification is more frequent in uterine serous carcinoma than ovarian serous carcinoma. J Surg Oncol. 2015;112:188-94
MATERIAL & METHODS
Figure 2. USC vs HGSOC
Figure 3. Post-Relapse Survival
We examined the clinical records of patients with USC and HGSOC who had been treated at our institute between and 2012.
Tumor stage was determined using the revised 2008 FIGO staging criteria for USC, and 1988 FIGO staging criteria for HGSOC.
The progression-free survival (PFS), overall survival (OS), and post-relapse survival (PRS) were estimated by means of the Kaplan-Meier method, and compared between the groups by means of the log- rank test. OS
PFS
USC
HGSOC
p = 0.053
2-year PRS
HGSOC: 76.6%
USC: 44.4%
USC
HGSOC
p =
p =
3-year OS
HGSOC: 87.0%
USC: 62.9%
median PFS
HGSOC: 49 mo.
USC: 21mo.
Contact information
OS and PFS were significantly shorter for USC than for HGSOC. (Figure 2)
PRS tended to be shorter for USC than for HGSOC. (Figure 3)
Hiroaki Nagano: