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The role of lymphadenectomy in patients with stage III&IV uterine serous carcinoma: Results of multicentric Turkish study - 13/01/21

Doi : 10.1016/j.jogoh.2021.102063 
Caner Cakir a , Fatih Kilic b, , Cigdem Kilic a , Nedim Tokgozoglu c , Burak Ersak b , Sevgi Ayhan b , Serra Akar b , Dilek Yuksel a , Vakkas Korkmaz a , Nurettin Boran a , Tayfun Toptas d , Gunsu Kimyon Comert b , Isin Ureyen d , Tolga Tasci c , Osman Turkmen b , Ozlem Moraloglu Tekin b , Yaprak Ustun a , Taner Turan b
a Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey 
b Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey 
c Department of Gynecologic Oncology, Okmeydanı Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey 
d Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey 

Corresponding author at: Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Bilkent Avenue, No:1 Post code:06800, Cankaya, Ankara, Turkey.Department of Gynecologic OncologyAnkara City HospitalUniversity of Health SciencesBilkent Avenue, No:1 Post code:06800CankayaAnkaraTurkey
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 13 January 2021

Abstract

Objective

The aim of this study was to evaluate clinicopathological features, oncological outcome and prognostic factors for recurrence in advanced stage uterine serous carcinoma (USC) patients.

Methods

Patients with 2009 International Federation of Gynecology and Obstetrics stage III&IV uterine serous carcinoma were enrolled from 4 gynecologic oncology centers and a study group was created. Response to therapy was evaluated according to the WHO criteria. Progression-free survival (PFS) and overall survival (OS) estimates were determinated by using the Kaplan-Meier method. Survival curves were compared with the log-rank test. Multivariate analysis was performed using the Cox proportional hazards model.

Results

Entire cohort included 63 patients. Median age of cohort was 64 years. Thirty-five (55.6%) patients were stage IV. Lymphadenectomy was performed in 57 (90.5%) patients and lymph node metastasis was positive in 45 (71.4%) patients. Maximal cytoreduction (no residue tumor) was achieved in 53 (84.1%) patients. However, optimal cytoreduction (residue tumor ≤1 cm) was achieved in 6 (9.5%) patients and suboptimal cytoreduction (residue tumor >1 cm) was achieved in 3 (4.8%) patients. Median follow-up time was 19 (range;1-152) months. Complete clinical response was obtained in 58 (92.1%) patients after standard adjuvant therapy. Disease failure was detected in 25 patients. Study group had a 2-year PFS of 51% and 2-year OS of 80%. On multivariate analysis, performing lymphadenectomy was an independent prognostic factor for PFS (Odds ratio: 24.794, 95% Confidence Interval: 4.214-145.869; p < 0.001).

Conclusion

Lymphadenectomy should be a part of the standard surgical therapy in advanced stage USC.

Le texte complet de cet article est disponible en PDF.

Keywords : Advanced stage, lymphadenectomy, uterine serous carcinoma, survival


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© 2021  Publié par Elsevier Masson SAS.
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