1.Prognostic factors and treatment outcomes in surgically-staged non-invasive uterine clear cell carcinoma: a Turkish Gynecologic Oncology Group study.
Mustafa Erkan SARI ; Mehmet Mutlu MEYDANLI ; Osman TÜRKMEN ; Günsü Kimyon CÖMERT ; Ahmet Taner TURAN ; Alper KARALÖK ; Hanifi ŞAHIN ; Ali HABERAL ; Eda KOCAMAN ; Ozgür AKBAYIR ; Baki ERDEM ; Ceyhun NUMANOĞLU ; Kemal GÜNGÖRDÜK ; Muzaffer SANCI ; Mehmet GÖKÇÜ ; Nejat ÖZGÜL ; Mehmet Coşkun SALMAN ; Gökhan BOYRAZ ; Kunter YÜCE ; Tayfun GÜNGÖR ; Salih TAŞKIN ; Duygun ALTIN ; Uğur Fırat ORTAÇ ; Hülya Aydın AYIK ; Tayup ŞIMŞEK ; Macit ARVAS ; Ali AYHAN
Journal of Gynecologic Oncology 2017;28(4):e49-
OBJECTIVE: To assess the prognosis of surgically-staged non-invasive uterine clear cell carcinoma (UCCC), and to determine the role of adjuvant therapy. METHODS: A multicenter, retrospective department database review was performed to identify patients with UCCC who underwent surgical treatment between 1997 and 2016 at 8 Gynecologic Oncology Centers. Demographic, clinicopathological, and survival data were collected. RESULTS: A total of 232 women with UCCC were identified. Of these, 53 (22.8%) had surgically-staged non-invasive UCCC. Twelve patients (22.6%) were upstaged at surgical assessment, including a 5.6% rate of lymphatic dissemination (3/53). Of those, 1 had stage IIIA, 1 had stage IIIC1, 1 had stage IIIC2, and 9 had stage IVB disease. Of the 9 women with stage IVB disease, 5 had isolated omental involvement indicating omentum as the most common metastatic site. UCCC limited only to the endometrium with no extra-uterine disease was confirmed in 41 women (73.3%) after surgical staging. Of those, 13 women (32%) were observed without adjuvant treatment whereas 28 patients (68%) underwent adjuvant therapy. The 5-year disease-free survival rates for patients with and without adjuvant treatment were 100.0% vs. 74.1%, respectively (p=0.060). CONCLUSION: Extra-uterine disease may occur in the absence of myometrial invasion (MMI), therefore comprehensive surgical staging including omentectomy should be the standard of care for women with UCCC regardless of the depth of MMI. Larger cohorts are needed in order to clarify the necessity of adjuvant treatment for women with UCCC truly confined to the endometrium.
Adenocarcinoma, Clear Cell
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Chemotherapy, Adjuvant
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Cohort Studies
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Disease-Free Survival
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Endometrium
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Female
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Humans
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Neoplasm Invasiveness
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Omentum
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Prognosis
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Retrospective Studies
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Standard of Care
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Uterine Diseases
Result Analysis
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