Prognostic factors and treatment outcomes in surgically-staged non-invasive uterine clear cell carcinoma: a Turkish Gynecologic Oncology Group study

Autor: Mehmet Coskun Salman, Kunter Yuce, Tayfun Güngör, Alper Karalok, Muzaffer Sanci, Ali Ayhan, Ozgur Akbayir, Gunsu Kimyon Comert, Kemal Güngördük, Mustafa Erkan Sari, Salih Taşkın, Ali Haberal, Hanifi Şahin, Macit Arvas, Mehmet Gökçü, Baki Erdem, Nejat Ozgul, Eda Kocaman, Gokhan Boyraz, Osman Turkmen, Duygun Altın, Uğur Fırat Ortaç, Tayup Simsek, Ceyhun Numanoglu, Hulya Ayik, Mehmet Mutlu Meydanli, Ahmet Taner Turan
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Oncology
Turkey
medicine.medical_treatment
Uterine Cervical Neoplasms
Endometrium
Clear Cell
0302 clinical medicine
Medicine
Stage (cooking)
Aorta
Peritoneal Neoplasms
Adjuvant
Aged
80 and over
Uterine Diseases
030219 obstetrics & reproductive medicine
Obstetrics and Gynecology
General Medicine
Middle Aged
Survival Rate
Treatment Outcome
Editorial
medicine.anatomical_structure
Chemotherapy
Adjuvant
Lymphatic Metastasis
030220 oncology & carcinogenesis
Uterine Neoplasms
Adenocarcinoma
Original Article
Female
Omentum
Adult
medicine.medical_specialty
Uterine clear-cell carcinoma
Gynecologic oncology
Disease-Free Survival
Pelvis
03 medical and health sciences
Uterine Corpus
Internal medicine
Adjuvant therapy
Chemotherapy
Humans
Neoplasm Invasiveness
Aged
Retrospective Studies
Radiotherapy
business.industry
Chemoradiotherapy
Adjuvant
medicine.disease
Surgery
Radiation therapy
Lymph Node Excision
Radiotherapy
Adjuvant
business
Adenocarcinoma
Clear Cell
Zdroj: Journal of Gynecologic Oncology
ISSN: 2005-0399
2005-0380
Popis: Objective: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. Methods: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. Results: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). Conclusion: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.
Databáze: OpenAIRE
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