Laura L Holman1, Navdeep Pal1, David A Iglesias1, Pamela T Soliman1, Nyla Balakrishnan1, Ann Klopp2, Russell R Broaddus3, Nicole D Fleming1, Mark F Munsell4, Karen H Lu1, Shannon N Westin5. 1. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. 2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. 3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. 5. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: swestin@mdanderson.org.
Abstract
OBJECTIVES: The study objective was to analyze the impact of prognostic factors, including treatment modality, on outcome in patients with advanced-stage uterine serous carcinoma (USC). METHODS: A retrospective review of patients diagnosed with stage III or IV USC between 1993 and 2012 was performed. Summary statistics were used to describe demographic and clinical characteristics. Overall survival (OS) and recurrence free survival (RFS) were estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to model the association of potential prognostic factors with OS and RFS. RESULTS: The study included 260 patients with median follow-up of 26.6months (range 1-172.8). Median age was 63years (range 30-88) and 52.3% had stage III disease. In all, 60% were treated with surgery followed by chemotherapy, 18.1% received surgery, chemotherapy, and radiotherapy, 11.5% had surgery and radiotherapy, and 10.4% had neoadjuvant chemotherapy. The overall complete response rate was 68.9%, and the cumulative incidence of recurrence was 82.7%. Treatment that included surgery, chemotherapy, and radiation and stage III disease were associated with improved RFS on multivariate analysis. For OS, therapy with surgery, chemotherapy, and radiation, mixed histology, and stage III disease were associated with better OS on multivariate analysis. CONCLUSIONS: Patients with advanced-stage USC have a poor prognosis, regardless of clinical factors or treatment received. However, combination therapy that includes chemotherapy and radiation appears to be associated with improved survival in these women.
OBJECTIVES: The study objective was to analyze the impact of prognostic factors, including treatment modality, on outcome in patients with advanced-stage uterine serous carcinoma (USC). METHODS: A retrospective review of patients diagnosed with stage III or IV USC between 1993 and 2012 was performed. Summary statistics were used to describe demographic and clinical characteristics. Overall survival (OS) and recurrence free survival (RFS) were estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to model the association of potential prognostic factors with OS and RFS. RESULTS: The study included 260 patients with median follow-up of 26.6months (range 1-172.8). Median age was 63years (range 30-88) and 52.3% had stage III disease. In all, 60% were treated with surgery followed by chemotherapy, 18.1% received surgery, chemotherapy, and radiotherapy, 11.5% had surgery and radiotherapy, and 10.4% had neoadjuvant chemotherapy. The overall complete response rate was 68.9%, and the cumulative incidence of recurrence was 82.7%. Treatment that included surgery, chemotherapy, and radiation and stage III disease were associated with improved RFS on multivariate analysis. For OS, therapy with surgery, chemotherapy, and radiation, mixed histology, and stage III disease were associated with better OS on multivariate analysis. CONCLUSIONS:Patients with advanced-stage USC have a poor prognosis, regardless of clinical factors or treatment received. However, combination therapy that includes chemotherapy and radiation appears to be associated with improved survival in these women.
Authors: Amanda Nickles Fader; David Starks; Paola A Gehrig; Angeles Alvarez Secord; Heidi E Frasure; David M O'Malley; Erin R Tuller; Peter G Rose; Laura J Havrilesky; Kathleen N Moore; Warner K Huh; Allison E Axtell; Joseph L Kelley; Kristine M Zanotti Journal: Gynecol Oncol Date: 2009-08-26 Impact factor: 5.482
Authors: Amanda Nickles Fader; Christa Nagel; Allison E Axtell; Kristine M Zanotti; Joseph L Kelley; Kathleen N Moore; Angeles Alvarez Secord; Christine S Walsh; Warner K Huh; Paola A Gehrig; Heidi Gibbons; Peter G Rose; Laura J Havrilesky; Erin Tuller; Richard D Drake; Justin Bottsford-Miller; David M O'Malley Journal: Gynecol Oncol Date: 2009-01-01 Impact factor: 5.482
Authors: Amanda Nickles Fader; Richard D Drake; David M O'Malley; Heidi E Gibbons; Warner K Huh; Laura J Havrilesky; Paola A Gehrig; Erin Tuller; Allison E Axtell; Kristine M Zanotti Journal: Cancer Date: 2009-05-15 Impact factor: 6.860
Authors: Jessica D Arden; Kimberly Marvin; Hong Ye; Lena Juratli; Sirisha R Nandalur; Zaid Al-Wahab; Jayson Field; Jill Gadzinski; Joseph Anthony Rakowski; Barry Rosen; Maha Saada Jawad Journal: Adv Radiat Oncol Date: 2020-10-24
Authors: Benjamin B Albright; Karen A Monuszko; Samantha J Kaplan; Brittany A Davidson; Haley A Moss; Allan B Huang; Alexander Melamed; Jason D Wright; Laura J Havrilesky; Rebecca A Previs Journal: Am J Obstet Gynecol Date: 2021-05-04 Impact factor: 10.693