Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen

Larissa J. Lee, Rebecca Demaria, Ross Berkowitz, Ursula Matulonis, Akila Viswanathan

Research output: Contribution to journalArticle

Abstract

Objective To identify clinical predictors of long-term survival in women with FIGO Stage IVB uterine papillary serous carcinoma (UPSC) confined to the abdomen Methods Records were reviewed for 48 patients with Stage IVB UPSC diagnosed from 1/1980 to 12/2011. Study inclusion required hysterectomy, salpingo-oophorectomy and negative chest imaging. Disease-free (DFS) and overall (OS) survival rates were calculated using the Kaplan-Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards. Results Median age at diagnosis was 70 years (range, 53-87). Optimal cytoreduction (Opt) to < 1 cm residual disease was performed in 36 patients (75%). With a median follow-up of 21 months for all patients and 99 months for survivors, 36 (75%) experienced disease progression or relapse, most commonly intraperitoneal (16, 44%). At 5 years, DFS and OS rates were 12% and 19%, respectively. Five patients (10%) were long-term survivors without relapse at a median of 124 months. All 5 had Opt and carboplatin/paclitaxel chemotherapy, and 4 received radiotherapy (2 pelvic, 1 whole-abdominal, 1 brachytherapy). On MVA in the chemotherapy-treated population, Opt (HR 0.09, 95% CI 0.02-0.35) and radiotherapy (HR 0.36, 0.15-0.80) were associated with decreased rates of recurrence or progression. Opt (HR 0.09, 0.02-0.38) was prognostic for OS when adjusted for age. Conclusions Clinical predictors of long-term survival for Stage IVB UPSC confined to the abdomen include optimal cytoreduction and adjuvant platinum and paclitaxel chemotherapy. Radiotherapy may decrease rates of recurrence or progression. Despite intra-abdominal involvement, disease remission and long-term survival may be achieved in some patients.

Original languageEnglish (US)
Pages (from-to)65-69
Number of pages5
JournalGynecologic Oncology
Volume132
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Fingerprint

Papillary Carcinoma
Abdomen
Survival
Recurrence
Radiotherapy
Paclitaxel
Drug Therapy
Survivors
Multivariate Analysis
Carboplatin
Brachytherapy
Ovariectomy
Platinum
Hysterectomy
Disease Progression
Thorax
Survival Rate
Population

Keywords

  • Endometrial cancer
  • FIGO Stage IVB
  • Non-endometrioid endometrial cancer
  • Optimal cytoreductive surgery
  • Uterine papillary serous carcinoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen. / Lee, Larissa J.; Demaria, Rebecca; Berkowitz, Ross; Matulonis, Ursula; Viswanathan, Akila.

In: Gynecologic Oncology, Vol. 132, No. 1, 01.2014, p. 65-69.

Research output: Contribution to journalArticle

Lee, Larissa J. ; Demaria, Rebecca ; Berkowitz, Ross ; Matulonis, Ursula ; Viswanathan, Akila. / Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen. In: Gynecologic Oncology. 2014 ; Vol. 132, No. 1. pp. 65-69.
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abstract = "Objective To identify clinical predictors of long-term survival in women with FIGO Stage IVB uterine papillary serous carcinoma (UPSC) confined to the abdomen Methods Records were reviewed for 48 patients with Stage IVB UPSC diagnosed from 1/1980 to 12/2011. Study inclusion required hysterectomy, salpingo-oophorectomy and negative chest imaging. Disease-free (DFS) and overall (OS) survival rates were calculated using the Kaplan-Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards. Results Median age at diagnosis was 70 years (range, 53-87). Optimal cytoreduction (Opt) to < 1 cm residual disease was performed in 36 patients (75{\%}). With a median follow-up of 21 months for all patients and 99 months for survivors, 36 (75{\%}) experienced disease progression or relapse, most commonly intraperitoneal (16, 44{\%}). At 5 years, DFS and OS rates were 12{\%} and 19{\%}, respectively. Five patients (10{\%}) were long-term survivors without relapse at a median of 124 months. All 5 had Opt and carboplatin/paclitaxel chemotherapy, and 4 received radiotherapy (2 pelvic, 1 whole-abdominal, 1 brachytherapy). On MVA in the chemotherapy-treated population, Opt (HR 0.09, 95{\%} CI 0.02-0.35) and radiotherapy (HR 0.36, 0.15-0.80) were associated with decreased rates of recurrence or progression. Opt (HR 0.09, 0.02-0.38) was prognostic for OS when adjusted for age. Conclusions Clinical predictors of long-term survival for Stage IVB UPSC confined to the abdomen include optimal cytoreduction and adjuvant platinum and paclitaxel chemotherapy. Radiotherapy may decrease rates of recurrence or progression. Despite intra-abdominal involvement, disease remission and long-term survival may be achieved in some patients.",
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T1 - Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen

AU - Lee, Larissa J.

AU - Demaria, Rebecca

AU - Berkowitz, Ross

AU - Matulonis, Ursula

AU - Viswanathan, Akila

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N2 - Objective To identify clinical predictors of long-term survival in women with FIGO Stage IVB uterine papillary serous carcinoma (UPSC) confined to the abdomen Methods Records were reviewed for 48 patients with Stage IVB UPSC diagnosed from 1/1980 to 12/2011. Study inclusion required hysterectomy, salpingo-oophorectomy and negative chest imaging. Disease-free (DFS) and overall (OS) survival rates were calculated using the Kaplan-Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards. Results Median age at diagnosis was 70 years (range, 53-87). Optimal cytoreduction (Opt) to < 1 cm residual disease was performed in 36 patients (75%). With a median follow-up of 21 months for all patients and 99 months for survivors, 36 (75%) experienced disease progression or relapse, most commonly intraperitoneal (16, 44%). At 5 years, DFS and OS rates were 12% and 19%, respectively. Five patients (10%) were long-term survivors without relapse at a median of 124 months. All 5 had Opt and carboplatin/paclitaxel chemotherapy, and 4 received radiotherapy (2 pelvic, 1 whole-abdominal, 1 brachytherapy). On MVA in the chemotherapy-treated population, Opt (HR 0.09, 95% CI 0.02-0.35) and radiotherapy (HR 0.36, 0.15-0.80) were associated with decreased rates of recurrence or progression. Opt (HR 0.09, 0.02-0.38) was prognostic for OS when adjusted for age. Conclusions Clinical predictors of long-term survival for Stage IVB UPSC confined to the abdomen include optimal cytoreduction and adjuvant platinum and paclitaxel chemotherapy. Radiotherapy may decrease rates of recurrence or progression. Despite intra-abdominal involvement, disease remission and long-term survival may be achieved in some patients.

AB - Objective To identify clinical predictors of long-term survival in women with FIGO Stage IVB uterine papillary serous carcinoma (UPSC) confined to the abdomen Methods Records were reviewed for 48 patients with Stage IVB UPSC diagnosed from 1/1980 to 12/2011. Study inclusion required hysterectomy, salpingo-oophorectomy and negative chest imaging. Disease-free (DFS) and overall (OS) survival rates were calculated using the Kaplan-Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards. Results Median age at diagnosis was 70 years (range, 53-87). Optimal cytoreduction (Opt) to < 1 cm residual disease was performed in 36 patients (75%). With a median follow-up of 21 months for all patients and 99 months for survivors, 36 (75%) experienced disease progression or relapse, most commonly intraperitoneal (16, 44%). At 5 years, DFS and OS rates were 12% and 19%, respectively. Five patients (10%) were long-term survivors without relapse at a median of 124 months. All 5 had Opt and carboplatin/paclitaxel chemotherapy, and 4 received radiotherapy (2 pelvic, 1 whole-abdominal, 1 brachytherapy). On MVA in the chemotherapy-treated population, Opt (HR 0.09, 95% CI 0.02-0.35) and radiotherapy (HR 0.36, 0.15-0.80) were associated with decreased rates of recurrence or progression. Opt (HR 0.09, 0.02-0.38) was prognostic for OS when adjusted for age. Conclusions Clinical predictors of long-term survival for Stage IVB UPSC confined to the abdomen include optimal cytoreduction and adjuvant platinum and paclitaxel chemotherapy. Radiotherapy may decrease rates of recurrence or progression. Despite intra-abdominal involvement, disease remission and long-term survival may be achieved in some patients.

KW - Endometrial cancer

KW - FIGO Stage IVB

KW - Non-endometrioid endometrial cancer

KW - Optimal cytoreductive surgery

KW - Uterine papillary serous carcinoma

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