Prognostic determinants in patients with stage IIIC and IV uterine papillary serous carcinoma
| Autor: | J. Alejandro Rauh-Hain, Whitfield B. Growdon, Annekathryn Goodman, Neil S. Horowitz, Marcela G. del Carmen, David M. Boruta, Christopher K. McCann, John O. Schorge |
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| Rok vydání: | 2010 |
| Předmět: |
Oncology
Adult medicine.medical_specialty medicine.medical_treatment FIGO Stage IIIC Disease-Free Survival Internal medicine Carcinoma medicine Humans Stage IIIC Stage (cooking) Survival rate Aged Neoplasm Staging Aged 80 and over Chemotherapy business.industry Proportional hazards model Obstetrics and Gynecology Middle Aged medicine.disease Carcinoma Papillary Cystadenocarcinoma Serous Radiation therapy Survival Rate Chemotherapy Adjuvant Uterine Neoplasms Female Radiotherapy Adjuvant business |
| Zdroj: | Gynecologic oncology. 119(2) |
| ISSN: | 1095-6859 |
| Popis: | Objective The aim of this study was to evaluate the survival impact of cytoreductive surgery and other prognostic determinants in patients with stage IIIC and IV uterine papillary serous carcinoma (UPSC). Methods All patients with FIGO stage IIIC and IV UPSC who underwent surgical staging at the two participating institutions, between January 1, 1995 and December 31, 2007, were identified from the tumor registry database. The Kaplan–Meier method was used to generate overall survival (OS) data. Factors predictive of outcome were compared using the log-rank test and Cox regression analysis. Results Analysis of 79 patients with stage IIIC–IV disease was performed. Optimal cytoreduction was associated with a median survival of 36months, compared with 12months for patients who underwent a suboptimal surgical effort ( p =0.001), and a disease-free survival (DFS) of 21months vs. 10months ( p =0.001), respectively. Regression analysis identified stage (HR=2.4, p =0.03), absence of visible residual disease (HR=0.5, p =0.03), and chemotherapy (HR=0.1, p Conclusions Cytoreduction to no gross residual disease and the use of platinum therapy are associated with a significant survival benefit for patients with stage IIIC–IV UPSC. Recommended management for this group of patients should consist of maximal surgical cytoreduction followed by platinum-based chemotherapy, preferably in combination with paclitaxel. Adjuvant radiation therapy should also be considered. |
| Databáze: | OpenAIRE |
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