The role of optimal debulking in advanced stage serous carcinoma of the uterus.
OBJECTIVE: To evaluate the role of optimal surgical cytoreduction and postoperative therapy in women with advanced uterine serous carcinoma (USC). METHODS: A multi-institutional, retrospective review identified 52 women with stage IV USC. Patient factors, surgical findings, and follow-up data were collected. Differences in demographics, surgical treatments, and adjuvant therapies administered were assessed with Fisher's exact test. Analysis of survival was performed using Kaplan-Meier and comparisons of survival were made using the log-rank test. RESULTS: Twenty-six women were optimally debulked ( 0.05). Median survival was longer in the optimal group (15 vs. 8 m), however, this did not reach statistical significance (P > 0.05). Women who received adjuvant platinum-based chemotherapy had a longer median survival than those who did not receive platinum chemotherapy (21 vs. 2 m) (P < 0.0001). Optimal cytoreduction combined with adjuvant therapy demonstrated a trend toward prolonged survival when compared to suboptimal cytoreduction combined with adjuvant therapy. However, the results did not achieve statistical significance (P > 0.05). CONCLUSION: Although no clear survival advantage is shown in the women who underwent optimal versus suboptimal debulking, there was a trend towards longer median survival in those who were maximally cytoreduced. Adjuvant platinum-based chemotherapy is associated with significantly longer survival in all women, regardless of amount of residual disease.
Moller, KA; Gehrig, PA; Van Le, L; Secord, AA; Schorge, J
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