The Comparison of Pure Uterine Serous Carcinoma and Mixed Tumor with Serous Component: a Single-institution Review of 91 Cases

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2024 Jan 17

PMID 38233757

Authors

Xuewu You

Yangyang Dong

Jiaqi Wang

Yuan Cheng

Yuanyuan Jia

Xiaobo Zhang

Jianliu Wang

Affiliations

Soon will be listed here.

Abstract

Background: Pure uterine serous carcinoma (p-USC) and mixed tumors with serous component (m-USC) are aggressive subtypes of endometrial cancer associated with high mortality rates. This retrospective study aimed to compare clinicopathologic features and outcomes of p-USC and m-USC in a single center.

Methods: This study retrospectively reviewed patients diagnosed with USC at Peking University People's Hospital between 2008 and 2022. T-tests and chi-square tests were used to compare clinicopathological characteristics between p-USC and m-USC. Kaplan-Meier survival curve and Cox regression analysis were used to analyze the impact of clinical and pathological variables on OS and PFS.

Results: Among the 91 patients who underwent surgery, 65.9% (n = 60) were p-USC, and 34.1% (n = 31) were m-USC. Patients with p-USC had earlier menopause (P = 0.0217), a lower rate of progesterone receptor(PR) expression (P < 0.001), and were more likely to have positive peritoneal cytology (P = 0.0464). After a median follow-up time of 40 months, 28 (46.7%) p-USC and 9 (29%) m-USC patients had progression disease, 18 (30%) and 8 (25.8%) patients died of their disease. 5-year PFSR were 51.2% and 75.3%, respectively, and 5-year OS rates were 66% and 67.4%. Kaplan-Meier survival analysis showed that p-USC was more likely to relapse than m-USC (P = 0.034), but there was no significant difference in OS. Cox regression analysis showed that lymph node metastasis and surgical approach were risk factors for OS, and myoinvasion depth ≥ 1/2 was an independent risk factor for PFS.

Conclusions: p-USC was more likely to relapse than m-USC, but there was no significant difference in OS between the two subtypes.

References

Vogel T, Knickerbocker A, Shah C, Schiff M, Isacson C, Garcia R . An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers. J Gynecol Oncol. 2014; 26(1):25-31. PMC: 4302281. DOI: 10.3802/jgo.2015.26.1.25. View

Roelofsen T, Mingels M, Hendriks J, Samlal R, Snijders M, Aalders A . Preoperative CA-125 predicts extra-uterine disease and survival in uterine papillary serous carcinoma patients. Int J Biol Markers. 2012; 27(3):e263-71. DOI: 10.5301/JBM.2012.9346. View

Sherman M . Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol. 2000; 13(3):295-308. DOI: 10.1038/modpathol.3880051. View

Milgrom S, Kollmeier M, Abu-Rustum N, Makker V, Gardner G, Barakat R . Positive peritoneal cytology is highly predictive of prognosis and relapse patterns in stage III (FIGO 2009) endometrial cancer. Gynecol Oncol. 2013; 130(1):49-53. DOI: 10.1016/j.ygyno.2013.04.013. View

Bogani G, Dowdy S, Cliby W, Ghezzi F, Rossetti D, Frigerio L . Management of endometrial cancer: issues and controversies. Eur J Gynaecol Oncol. 2016; 37(1):6-12. View

Tortorella L, Langstraat C, Weaver A, McGree M, Bakkum-Gamez J, Dowdy S . Uterine serous carcinoma: Reassessing effectiveness of platinum-based adjuvant therapy. Gynecol Oncol. 2018; 149(2):291-296. DOI: 10.1016/j.ygyno.2018.02.022. View

Cham S, Huang Y, Tergas A, Hou J, Burke W, Deutsch I . Utility of radiation therapy for early-stage uterine papillary serous carcinoma. Gynecol Oncol. 2017; 145(2):269-276. DOI: 10.1016/j.ygyno.2017.03.003. View

Momeni-Boroujeni A, Dahoud W, Vanderbilt C, Chiang S, Murali R, Rios-Doria E . Clinicopathologic and Genomic Analysis of -Mutated Endometrial Carcinomas. Clin Cancer Res. 2021; 27(9):2613-2623. PMC: 8530276. DOI: 10.1158/1078-0432.CCR-20-4436. View

Matsuo K, Matsuzaki S, Nusbaum D, Machida H, Nagase Y, Grubbs B . Malignant peritoneal cytology and decreased survival of women with stage I endometrioid endometrial cancer. Eur J Cancer. 2020; 133:33-46. PMC: 7772941. DOI: 10.1016/j.ejca.2020.03.031. View

10.

Shimizu M, Yamanaka K, Azumi M, Tomimoto M, Washio K, Takahashi R . A case of synchronous serous ovarian cancer and uterine serous endometrial intraepithelial carcinoma. J Ovarian Res. 2021; 14(1):87. PMC: 8244197. DOI: 10.1186/s13048-021-00835-8. View

11.

Sherman M, Bitterman P, Rosenshein N, Delgado G, Kurman R . Uterine serous carcinoma. A morphologically diverse neoplasm with unifying clinicopathologic features. Am J Surg Pathol. 1992; 16(6):600-10. DOI: 10.1097/00000478-199206000-00008. View

12.

Crosbie E, Kitson S, McAlpine J, Mukhopadhyay A, Powell M, Singh N . Endometrial cancer. Lancet. 2022; 399(10333):1412-1428. DOI: 10.1016/S0140-6736(22)00323-3. View

13.

Lee E, Fader A, Santin A, Liu J . Uterine serous carcinoma: Molecular features, clinical management, and new and future therapies. Gynecol Oncol. 2020; 160(1):322-332. DOI: 10.1016/j.ygyno.2020.10.017. View

14.

Mahdi H, Elshaikh M, DeBenardo R, Munkarah A, Isrow D, Singh S . Impact of adjuvant chemotherapy and pelvic radiation on pattern of recurrence and outcome in stage I non-invasive uterine papillary serous carcinoma. A multi-institution study. Gynecol Oncol. 2015; 137(2):239-44. DOI: 10.1016/j.ygyno.2015.01.544. View

15.

Lavie O, Hornreich G, Ben Arie A, Renbaum P, Levy-Lahad E, Beller U . BRCA1 germline mutations in women with uterine serous papillary carcinoma. Obstet Gynecol. 2000; 96(1):28-32. DOI: 10.1016/s0029-7844(00)00851-6. View

16.

Bokhman J . Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983; 15(1):10-7. DOI: 10.1016/0090-8258(83)90111-7. View

17.

Fader A, Starks D, Gehrig P, Secord A, Frasure H, OMalley D . An updated clinicopathologic study of early-stage uterine papillary serous carcinoma (UPSC). Gynecol Oncol. 2009; 115(2):244-8. DOI: 10.1016/j.ygyno.2009.07.030. View

18.

Zhong X, Wang J, Kaku T, Wang Z, Li X, Wei L . Prognostic Factors of Uterine Serous Carcinoma-A Multicenter Study. Int J Gynecol Cancer. 2018; 28(6):1138-1144. DOI: 10.1097/IGC.0000000000001272. View

19.

Tymon-Rosario J, Gorman M, Santin A . Targeted Therapies in the Treatment of Uterine Serous Carcinoma. Curr Treat Options Oncol. 2022; 23(12):1804-1817. DOI: 10.1007/s11864-022-01030-7. View

20.

Growdon W, Rauh-Hain J, Cordon A, Garrett L, Schorge J, Goodman A . Prognostic determinants in patients with stage I uterine papillary serous carcinoma: a 15-year multi-institutional review. Int J Gynecol Cancer. 2012; 22(3):417-24. DOI: 10.1097/IGC.0b013e31823c6e36. View