Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.
Int J Gynecol Cancer. 2012 Oct;22(8):1355-60. doi: 10.1097/IGC.0b013e318267f7a0.
To assess the pattern of failures and the survival of patients with uterine papillary serous carcinoma (UPSC).
The hospital records of 119 women with UPSC were reviewed. Surgery was the initial therapy for all the cases. The median follow-up of survivors was 133 months (range, 3-216 months).
Postoperative treatment was used in 98 patients (82.4%). Adjuvant treatment was radiotherapy in 25 women, chemotherapy in 61 women, and chemotherapy plus radiotherapy in 12 women. Tumor recurred in 44 (37.0%) of the 119 patients, after a median time of 15.1 months. Relapse was symptomatic in 15 patients (34.1%), and recurrent disease involved peritoneum or distant sites in 26 (66.7%) of the 39 patients for whom the site of failure was known. Five- and 10-year survival rates were 61.8% and 54.6%, respectively. Survival was related to disease stage (P < 0.0001). Among patients with advanced tumor, 5-year survival was lower in women who had macroscopic residual disease after surgery than in those who had not (15.4% vs 37.5%; P = 0.08). Distant failures were higher in women with histologically proven positive nodes than in those with negative nodes (28.6% vs 9.1%; P = 0.048). There was a trend to better survival for patients with stage I to stage II disease who underwent chemotherapy when compared with those who did not.
Uterine papillary serous carcinoma has an aggressive clinical behavior with a great tendency to recur especially in peritoneal and distant sites. Tumor stage is a strong prognostic factor, whereas the role of adjuvant treatment is still uncertain.
评估子宫乳头状浆液性癌（UPSC）患者的失败模式和生存率。
回顾了 119 例 UPSC 女性患者的医院记录。所有病例均采用手术作为初始治疗。幸存者的中位随访时间为 133 个月（范围 3-216 个月）。
98 例患者（82.4%）接受了术后治疗。25 例患者接受放疗，61 例患者接受化疗，12 例患者接受化疗加放疗。119 例患者中有 44 例（37.0%）出现肿瘤复发，中位复发时间为 15.1 个月。15 例（34.1%）患者出现症状性复发，39 例已知失败部位的患者中，26 例（66.7%）复发疾病累及腹膜或远处部位。5 年和 10 年生存率分别为 61.8%和 54.6%。生存与疾病分期有关（P<0.0001）。在晚期肿瘤患者中，手术后有肉眼残留病灶的患者 5 年生存率低于无肉眼残留病灶的患者（15.4%比 37.5%；P=0.08）。组织学证实有阳性淋巴结的患者远处转移率高于无阳性淋巴结的患者（28.6%比 9.1%；P=0.048）。与未接受化疗的Ⅰ期至Ⅱ期疾病患者相比，接受化疗的患者有更好的生存趋势。
子宫乳头状浆液性癌具有侵袭性的临床行为，尤其是在腹膜和远处部位有较高的复发倾向。肿瘤分期是一个强有力的预后因素，而辅助治疗的作用仍不确定。
