Satoru Sagae1, Nobuyuki Susumu, Akila N Viswanathan, Daisuke Aoki, Floor J Backes, Diane M Provencher, Michelle Vaughan, Carien L Creutzberg, Christian Kurzeder, Gunnar Kristensen, Chulmin Lee, Jean-Emmanuel Kurtz, Rosalind M Glasspool, William Small. 1. *Department of Obstetrics & Gynecology, JR Sapporo Hospital, Sapporo, Japan; †Department of Obstetrics & Gynecology, School of Medicine, Keio University, Tokyo; ‡Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA; §Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus, OH; ∥Centre Hospitalier de L'Université de Montréal, Montreal, Quebec, Canada; ¶Oncology Department, Christchurch Hospital, Canterbury, New Zealand; #Department of Clinical Oncology, Leiden University Medical Center, Leiden, the Netherlands; **Department Gynecology & Gynecologic Oncology, Kliniken Essen Mitte (KEM) (AGO), Essen, Germany; ††Norwegian Radium Hospital, Oslo, Norway; ‡‡Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, Seoul, South Korea; §§Department of Oncology and Hematology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ∥∥Beatson West of Scotland Cancer Centre, Glasgow, Scotland; and ¶¶Department of Radiation Oncology, Stritch School of Medicine Loyola University, Chicago, IL.
Abstract
OBJECTIVES: Uterine 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. METHODS: As 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. RESULTS: Both 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 P53 mutations. 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. CONCLUSIONS: Uterine 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.
OBJECTIVES: Uterine 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. METHODS: As 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. RESULTS: Both 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 P53 mutations. 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. CONCLUSIONS: Uterine 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.
Authors: Maria B Schiavone; Chiara Scelzo; Celeste Straight; Qin Zhou; Kaled M Alektiar; Vicky Makker; Robert A Soslow; Alexia Iasonos; Mario M Leitao; Nadeem R Abu-Rustum Journal: Ann Surg Oncol Date: 2017-03-03 Impact factor: 5.344
Authors: Ziwei Fang; Jiandong Wang; Leslie H Clark; Wenchuan Sun; Yajie Yin; Weimin Kong; Stuart R Pierce; Lindsay West; Stephanie A Sullivan; Arthur-Quan Tran; Varun V Prabhu; Chunxiao Zhou; Victoria Bae-Jump Journal: Am J Cancer Res Date: 2018-08-01 Impact factor: 6.166
Authors: Stephanie Lheureux; Carolyn McCourt; B J Rimel; Linda Duska; Gini Fleming; Helen Mackay; David Mutch; Sarah M Temkin; Jean Lynn; Elise C Kohn Journal: Gynecol Oncol Date: 2018-02-22 Impact factor: 5.304