Naumann R Wendel
Blumenthal Cancer Center, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 600, Charlotte, NC 28203, USA.
Curr Oncol Rep. 2008 Nov;10(6):505-11. doi: 10.1007/s11912-008-0076-x.
Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer that is likely to present with deep myometrial invasion and lymph vascular involvement. By the time most affected women are diagnosed, the UPSC has spread outside the uterus. Because many reports include patients who are not completely staged, the risk of recurrence in stage I patients has likely been overestimated. Recently, several large series of well-staged patients have demonstrated that survival in stage I patients is similar to that of poorly differentiated endometrioid tumors. Because of the high risk of extrauterine spread, all patients with UPSC should have an extended surgical staging procedure, including lymphadenectomy and omentectomy. Chemotherapy with or without local or regional radiation is probably the most effective adjuvant therapy in both early and advanced disease. Because patients with stage I UPSC are still at significant risk of recurrence, adjuvant therapy is often recommended for all patients. It has been difficult to conduct prospective randomized trials for patients with UPSC because of the rare nature of these cancers.
子宫浆液性乳头状癌（UPSC）是一种侵袭性子宫内膜癌，很可能出现子宫肌层深部浸润和淋巴管受累。在大多数受影响的女性被诊断出来时，UPSC已经扩散到子宫外。由于许多报告纳入了分期不完全的患者，I期患者的复发风险可能被高估了。最近，几个大型的分期良好的患者系列研究表明，I期患者的生存率与低分化子宫内膜样肿瘤相似。由于子宫外扩散风险高，所有UPSC患者都应进行扩大手术分期，包括淋巴结清扫术和大网膜切除术。在早期和晚期疾病中，化疗联合或不联合局部或区域放疗可能是最有效的辅助治疗方法。由于I期UPSC患者仍有较高的复发风险，通常建议所有患者接受辅助治疗。由于这些癌症较为罕见，很难对UPSC患者进行前瞻性随机试验。
