A new aggressive treatment approach to high-grade endometrial cancer of possible benefit to patients with stage I uterine papillary cancer.

Between January 1, 1988 and December 31, 1990, a new high-intensity treatment was delivered to 10 patients with clinical stage I uterine papillary serous carcinoma (UPSC) and 21 patients with clinical stage I, FIGO grade 3 endometrial adenocarcinoma. The treatment consisted of a radical hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node sampling, adjuvant external pelvic radiation, and four courses of cis-platinum/epirubicin. The clinical outcome was compared to that of a historical control group treated before 1988 with surgery and radiation. None of the high-intensity treated UPSC patients died or relapsed during a median observation time of 32 months. There was a significantly better survival in the high-intensity treated UPSC group compared to the controls. The UPSC patients diagnosed after January 1, 1988 showed a trend toward better survival compared to those diagnosed before this date, whether they had received high-intensity treatment or not. No significant difference in survival was observed in the non-UPSC group subjected or not to the high-intensity treatment.