Comparison of outcomes in early-stage uterine clear cell carcinoma and serous carcinoma Journal Article

Authors: Zhang, M.; Yang, T. J.; Desai, N. B.; DeLair, D.; Kollmeier, M. A.; Makker, V.; Leitao, M. M. Jr; Abu-Rustum, N. R.; Alektiar, K. M.
Article Title: Comparison of outcomes in early-stage uterine clear cell carcinoma and serous carcinoma
Abstract: Purpose: The treatment paradigm for uterine clear cell carcinoma is often linked to serous carcinoma. This study compares oncologic outcomes between women with uterine clear cell and serous carcinoma. Methods and Materials: We reviewed 114 women with stage I–II uterine clear cell carcinoma (n = 17, 15%) or serous carcinoma (n = 97, 85%) who underwent hysterectomy and salpingo-oophorectomy at our institution from April 1992 to December 2011; 86 (76%) had stage IA, 14 (12%) had stage IB, and 14 (12%) had stage II disease. Median followup was 57 months. Results: Patients with uterine clear cell and serous carcinoma did not differ significantly by age ≥60 years, stage, or rate of lymphovascular invasion. There was no difference in the number of patients with clear cell or serous histology who received adjuvant radiotherapy (71% vs. 84%, respectively; p = 0.31); however, significantly fewer patients with clear cell histology received adjuvant chemotherapy (35% vs. 67%, respectively; p = 0.02). At 5 years, there were no significant differences in disease-free survival (94% vs. 84%, respectively; p = 0.27), disease-specific survival (100% vs. 92%, respectively; p = 0.20), or overall survival (100% vs. 89%, respectively; p = 0.34). The differences in chemotherapy utilization did not impact pattern of relapse, specifically peritoneal spread (7% vs. 6%, respectively; p = 0.92) or other distant sites (0% vs. 9%, respectively; p = 0.17). Conclusions: Oncologic outcomes and recurrence patterns of women with stage I–II uterine clear cell carcinoma compared favorably with those of women with serous carcinoma, despite significantly less adjuvant chemotherapy use. Potential reduction in adjuvant therapy in women with clear cell carcinoma should be studied prospectively. © 2018 American Brachytherapy Society
Keywords: adult; cancer survival; treatment outcome; aged; major clinical study; overall survival; cancer recurrence; paclitaxel; comparative study; disease free survival; chemotherapy; cancer staging; follow up; endometrium carcinoma; hysterectomy; salpingooophorectomy; carboplatin; multiple cycle treatment; histology; distant metastasis; docetaxel; early cancer; adjuvant chemotherapy; brachytherapy; radiation therapy; clear cell carcinoma; peritoneum metastasis; adjuvant radiotherapy; disease specific survival; cancer prognosis; lymph vessel metastasis; uterine clear cell carcinoma; human; female; priority journal; article; early-stage endometrial cancer; uterine serous cell carcinoma
Journal Title: Brachytherapy
Volume: 18
Issue: 1
ISSN: 1538-4721
Publisher: Elsevier Science, Inc.  
Date Published: 2019-01-01
Start Page: 38
End Page: 43
Language: English
DOI: 10.1016/j.brachy.2018.08.015
PUBMED: 30316723
PROVIDER: scopus
Notes: Export Date: 1 February 2019 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Vicky Makker
    71 Makker
  2. Kaled M Alektiar
    247 Alektiar
  3. Mario Leitao
    304 Leitao
  4. Marisa A Kollmeier
    144 Kollmeier
  5. Neil B Desai
    35 Desai
  6. Deborah F DeLair
    85 DeLair
  7. T. Jonathan Yang
    63 Yang
  8. Minsi Zhang
    5 Zhang