OBJECTIVE: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), they contribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis is lacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiary care cancer centers. METHODS: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to 2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their association with overall survival (OS) and progression-free survival (PFS). RESULTS: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patients presented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0% and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improved OS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS based on the performance of a paraaoritc lymph node dissection. CONCLUSION: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC and was not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.
Adenocarcinoma, Clear Cell/pathology/secondary/*therapy ; Aged ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Papillary/pathology/secondary/*therapy ; Cystadenocarcinoma, Serous/pathology/secondary/*therapy ; Female ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Professional Practice ; Radiotherapy, Adjuvant ; Retrospective Studies ; Robotic Surgical Procedures ; Survival Analysis ; Treatment Outcome ; Uterine Neoplasms/pathology/*therapy

OBJECTIVETo analyze the retroperitoneal lymph node metastasis in epithelial cancer of the ovary and offer scientific indications for lymph node radical dissection.

METHODSFifty-eight patients with ovarian cancer treated from January 1990 to December 2000 were retrospectively reviewed. Single-factor and multifactor analysis with Logistic regression model were performed by SPSS 10.0 statistic software.

RESULTSThe metastasis rates of overall lymph nodes, pelvic nodes and para-aortic nodes were 48.3%, 37.9% and 25.9% respectively, among which no significant difference was noted (P > 0.05). Single-factor analysis showed that tumor location, ascitic condition, clinical stage and the size of residual tumor were associated with retroperitoneal lymph node metastasis. Multifactor analysis revealed that clinical stage and size of residual tumor were independent risk factors for metastasis of retroperitoneal lymph nodes.

CONCLUSIONFor early ovarian cancer patients, it is extremely important to perform radical dissection of the retroperitoneal lymph nodes. For advanced or residual lesions, radical dissection of pelvic nodes and para-aortic nodes could be considered in the second exploration.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Cystadenocarcinoma, Mucinous ; drug therapy ; secondary ; surgery ; Cystadenocarcinoma, Serous ; drug therapy ; secondary ; surgery ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Ovarian Neoplasms ; drug therapy ; pathology ; surgery ; Retroperitoneal Space ; Retrospective Studies ; Second-Look Surgery