Adjuvant therapy in early uterine serous carcinoma

Abstract

Uterine serous carcinoma (USC) is a rare diagnosis but is associated with high mortality. There are limited data to guide adjuvant treatment decisions in early-stage disease. The purpose of this study is to evaluate the impact of adjuvant therapy on recurrence-free survival (RFS) and overall survival (OS) in early-stage USC. Patients with stage I and II USC treated at a single institution from January 2006 to December 2019 were identified. Demographic, clinicopathologic, treatment, and outcome data were collected. Data were compared using descriptive statistics. Survival analyses were performed using Kaplan-Meier and Cox proportional hazards methods. Ninety-four patients were identified. Median follow-up time was 33.5 months. The median age was 68 years (range, 49-87), the majority of patients were White (n = 78, 83.0%), and the median BMI was 30.7 (range, 14.2-57.3). Minimally invasive surgical staging was performed in 59.6% of cases (n = 56). Most patients had stage IA disease (n = 70, 74.5%). Most patients (n = 79, 84.0%) received adjuvant therapy, and a majority of patients received a combination of systemic chemotherapy and radiation therapy (n = 55, 58.5%), with the most common combination being chemotherapy plus vaginal brachytherapy (n = 42, 44.7%). Most patients (n = 77, 81.9%) remain without evidence of disease, while 17 patients (18.1%) have recurred. Patients receiving 6 cycles of adjuvant chemotherapy experienced improved OS (P =.004) and improved RFS (P =.02) compared to those receiving no adjuvant chemotherapy. Patients with early-stage USC who received 6 cycles of adjuvant chemotherapy had significantly improved OS and RFS when compared to those patients who did not receive adjuvant chemotherapy. This article is part of a Special Collection on Gynecological Cancer.