Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Gynecol Oncol. 2011 Dec;123(3):542-7. doi: 10.1016/j.ygyno.2011.09.005. Epub 2011 Oct 2.
To identify prognostic and predictive factors of overall survival (OS), relapse-free survival (RFS) and toxicity for patients with uterine papillary serous carcinoma (UPSC).
Patient, tumor, treatment and relapse characteristics of 135 women with Stages I-IVA UPSC treated between 1980 and 2006 at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) were analyzed using Cox regression models to determine prognostic and predictive factors for OS, RFS and toxicity.
Mean follow-up was 5.5 years (range, 0.01-25.2). Median 5-year OS was 52%, and RFS was 42% for all patients. On Cox regression analysis, increasing age, stage, and myometrial invasion were prognostic factors associated with shorter OS and RFS. A paclitaxel-platinum chemotherapy regimen was significantly associated with longer OS (hazard ratio [HR]=0.34, 95% confidence interval [CI] 0.15-0.74, p=0.007) and RFS (HR=0.45, 95% CI 0.22-0.92, p=0.03). RFS was improved for patients treated with RT (HR=0.44, 95% CI 0.25-0.77, p=0.004). The 5-year grade 3+ toxicity rate was 3.5% for those who received RT and was 2.9% for those who did not (p=NS).
Uterine papillary serous cancer can be an aggressive tumor type with a poor prognosis. RFS was improved by radiation and chemotherapy with few grade 3 or higher complications. Using radiation and paclitaxel-platinum chemotherapy should be attempted whenever feasible for patients with UPSC who do not have distant metastases at diagnosis.
确定子宫乳头状浆液性癌（UPSC）患者总生存（OS）、无复发生存（RFS）和毒性的预后和预测因素。
分析了 1980 年至 2006 年在 Dana-Farber/Brigham 和妇女癌症中心（DF/BWCC）治疗的 135 例 I-IVA 期 UPSC 患者的患者、肿瘤、治疗和复发特征，使用 Cox 回归模型确定 OS、RFS 和毒性的预后和预测因素。
中位随访时间为 5.5 年（范围，0.01-25.2）。所有患者的 5 年中位 OS 为 52%，RFS 为 42%。在 Cox 回归分析中，年龄、分期和肌层浸润增加是与 OS 和 RFS 较短相关的预后因素。紫杉醇-铂化疗方案与较长的 OS（风险比[HR]=0.34，95%置信区间[CI]0.15-0.74，p=0.007）和 RFS（HR=0.45，95%CI 0.22-0.92，p=0.03）显著相关。接受 RT 治疗的患者 RFS 改善（HR=0.44，95%CI 0.25-0.77，p=0.004）。接受 RT 治疗的患者 5 年 3+级毒性发生率为 3.5%，未接受 RT 治疗的患者为 2.9%（p=NS）。
子宫乳头状浆液性癌可能是一种侵袭性肿瘤类型，预后不良。放疗和化疗可改善 RFS，且并发症很少达到 3 级或更高级别。对于没有远处转移的 UPSC 患者，只要有可能，应尝试使用放疗和紫杉醇-铂化疗。
