دورية أكاديمية
أعرض في EDS

Adjuvant therapy in women with early stage uterine serous carcinoma: A multi-institutional study.

التفاصيل البيبلوغرافية
العنوان: Adjuvant therapy in women with early stage uterine serous carcinoma: A multi-institutional study.
المؤلفون: Kurnit KC; University of Chicago Medicine, Chicago, IL, USA., Nobre SP; University of Iowa, Iowa City, IA, USA., Fellman BM; University of Texas MD Anderson Cancer Center, Houston, TX, USA., Iglesias DA; Virginia Tech Carilion, Roanoke, VA, USA., Lindemann K; The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway., Jhingran A; University of Texas MD Anderson Cancer Center, Houston, TX, USA., Eriksson AGZ; The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway., Ataseven B; Kliniken Essen-Mitte, Essen, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Germany., Glaser GE; The Mayo Clinic, Rochester, MN, USA., Mueller JJ; Memorial Sloan Kettering Cancer Center, New York City, NY, USA., Westin SN; University of Texas MD Anderson Cancer Center, Houston, TX, USA., Soliman PT; University of Texas MD Anderson Cancer Center, Houston, TX, USA.. Electronic address: psoliman@mdanderson.org.
المصدر: Gynecologic oncology [Gynecol Oncol] 2022 Dec; Vol. 167 (3), pp. 452-457. Date of Electronic Publication: 2022 Oct 13.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, Academic Press.
مواضيع طبية MeSH: Cystadenocarcinoma, Serous*/pathology , Uterine Neoplasms*/pathology , Brachytherapy* , Endometrial Neoplasms*/pathology, Humans ; Female ; Retrospective Studies ; Chemotherapy, Adjuvant ; Hysterectomy ; Neoplasm Staging ; Radiotherapy, Adjuvant
مستخلص: Objective: Uterine serous carcinoma is a rare but aggressive subtype of endometrial adenocarcinoma. Our objective was to compare adjuvant treatment strategies for patients with early stage uterine serous carcinoma.
Methods: This multi-institutional, retrospective cohort study evaluated patients with early stage uterine serous carcinoma. Patients with FIGO Stage IA-II disease after surgery, whose tumors had serous or any mixed serous/non-serous histology were included. Patients with carcinosarcoma were excluded. Clinical data were abstracted from local medical records. Summary statistics, Fisher's exact, and Kruskal-Wallis tests were used to analyze demographic and clinical characteristics. Univariable and multivariable analyses were performed for recurrence-free and overall survival.
Results: There were 737 patients included. Most patients had Stage IA disease (75%), 49% of which had no myometrial invasion. Only 164 (24%) tumors had lymphatic/vascular space invasion. Adjuvant treatment varied: 22% received no adjuvant therapy, 17% had chemotherapy alone, 19% had cuff brachytherapy, 35% had cuff brachytherapy with chemotherapy, and 6% underwent pelvic radiation. Adjuvant treatment was significantly associated with a decreased risk of recurrence (p = 0.04). Compared with no adjuvant therapy, patients who received brachytherapy or brachytherapy/chemotherapy had improved recurrence-free survival (HR 0.59, 95% CI 0.40-0.86; HR 0.65, 95% CI 0.49-0.88, respectively) and overall survival (HR 0.53, 95% CI 0.35-0.79; HR 0.49, 95% CI 0.35-0.69, respectively). Improved survival with brachytherapy and brachytherapy/chemotherapy persisted on multivariable analyses. Chemotherapy alone was also associated with improved overall survival compared with no adjuvant treatment (HR 0.55, 95% CI 0.37-0.81).
Conclusions: Adjuvant therapy was associated with a decreased risk of recurrence relative to observation alone. Adjuvant cuff brachytherapy with and without chemotherapy was associated with improved survival outcomes in patients with early stage uterine serous carcinoma.
Competing Interests: Declaration of Competing Interest KCK reports: advisory board (LEAP Therapeutics), outside the submitted work; BMF reports: research support to his institution for the submitted work (MD Anderson Cancer Center Support Grant [CA016672]); DAI reports: advisory board (Novocure), outside the submitted work; KL reports: research support to her institution (GSK) and advisory board roles (AstraZeneca, Eisai, GSK, MSD), outside the submitted work; BA reports: payment or honoraria (Roche, Eisai, AstraZeneca, Celgene, MSD, Novartis), advisory board (Roche, MSD, GSK), and travel support (Roche, GSK), all outside the submitted work; SNW reports: research support to her institution for the submitted work (NCI SPORE for Uterine Cancer [2P50 CA098258-06]), and research support to her institution (AstraZeneca, Bayer, Clovis Oncology, Cotinga Pharmaceuticals, GSK, Mereo, Novartis, OncXerna, Roche/Genentech, Zentalis) and consulting fees (Agenus, AstraZeneca, Clovis Oncology, Eisai, EQRX, GSK, Immunogen, Lilly, Merck, Mereo, Novartis, Roche/Genentech, Zentalis), outside the submitted work. PTS reports: research support (Incyte, Novartis), consulting (Medscape) and advisory board (Amgen, Eisai), all outside the submitted work.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
References: Int J Gynecol Cancer. 2008 Jul-Aug;18(4):820-4. (PMID: 17892450)
Int J Radiat Oncol Biol Phys. 2003 Nov 15;57(4):1004-9. (PMID: 14575831)
Gynecol Oncol. 2020 Oct;159(1):17-22. (PMID: 32709539)
Gynecol Oncol. 1999 Sep;74(3):385-94. (PMID: 10479498)
Gynecol Oncol. 2017 May;145(2):269-276. (PMID: 28343693)
Gynecol Oncol. 2009 Mar;112(3):558-62. (PMID: 19118888)
Gynecol Oncol. 2005 Sep;98(3):353-9. (PMID: 16005947)
J Clin Oncol. 2020 Oct 10;38(29):3388-3397. (PMID: 32749941)
J Contemp Brachytherapy. 2020 Feb;12(1):61-66. (PMID: 32190072)
Int J Gynecol Cancer. 2020 Aug;30(8):1089-1094. (PMID: 32675056)
Brachytherapy. 2017 Jul - Aug;16(4):841-846. (PMID: 28511891)
Gynecol Oncol. 2003 Dec;91(3):470-5. (PMID: 14675664)
Br J Cancer. 2006 Mar 13;94(5):642-6. (PMID: 16495918)
J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686)
Gynecol Oncol. 2018 May;149(2):283-290. (PMID: 29544706)
Int J Gynecol Cancer. 2016 Mar;26(3):491-6. (PMID: 26825823)
Gynecol Oncol. 2003 Dec;91(3):463-9. (PMID: 14675663)
CA Cancer J Clin. 2021 Jan;71(1):7-33. (PMID: 33433946)
Cancer. 2009 May 15;115(10):2119-27. (PMID: 19306417)
Int J Radiat Oncol Biol Phys. 1998 Jan 1;40(1):77-84. (PMID: 9422561)
J Clin Oncol. 2019 Jul 20;37(21):1810-1818. (PMID: 30995174)
Gynecol Oncol. 2013 Dec;131(3):598-603. (PMID: 24135679)
معلومات مُعتمدة: P30 CA008748 United States CA NCI NIH HHS; P30 CA016672 United States CA NCI NIH HHS; P50 CA098258 United States CA NCI NIH HHS
فهرسة مساهمة: Keywords: Adjuvant therapy; Brachytherapy; Endometrial cancer; Uterine serous carcinoma
تواريخ الأحداث: Date Created: 20221015 Date Completed: 20221216 Latest Revision: 20231202
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10278585
DOI: 10.1016/j.ygyno.2022.09.025
PMID: 36243601
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-6859
DOI:10.1016/j.ygyno.2022.09.025