Use of chemotherapy or vaginal brachytherapy (VBT) may improve survival among patients with early-stage uterine papillary serous carcinoma (UPSC), according to a study presented at the 48th Annual Meeting of the Society of Gynecologic Oncology.1
Patients with early-stage UPSC have a poor prognosis and the efficacy of adjuvant radiation and chemotherapy are not well-studied. The purpose of this analysis was to determine the effect of chemotherapy, VBT, and external beam radiotherapy (EBRT) on survival in this population.
The analysis included data from the National Cancer Data Base from 1998 to 2012 of 7325 women with stage I to II UPSC who underwent primary surgery. Overall, 62% of the cohort had stage IA, 14.6% had stage IB, and 18.1% had stage II disease.
Among the cohort, 37.9% received chemotherapy, 19.6% underwent VBT, and 17.7% underwent EBRT.
A multivariate analysis demonstrated that prolonged survival was associated with chemotherapy (HR, 0.76; 95% CI, 0.67-0.86) and VBT (HR, 0.67; 95% CI, 0.57-0.78). The survival benefit with VBT remained with or without the use of adjuvant chemotherapy. EBRT was not associated with survival.
These results suggest that there is likely little benefit to use of EBRT in early-stage UPSC, but chemotherapy and VBRT with or without adjuvant chemotherapy may prolong survival.
1. Cham S, Huang Y, Deutsch I, et al. Patterns of use and outcomes of adjuvant chemotherapy and radiation for early-stage uterine papillary serous carcinoma. Presented at: 48th Annual Meeting of the Society of Gynecologic Oncology; March 12-15, 2017; National Harbor, MD.