Factors prognostic of survival in advanced stage uterine papillary serous carcinoma
OBJECTIVES: The study objective was to analyze the impact of prognostic factors, including treatment modality, on overall survival (OS) and recurrence free survival (RFS) in patients with advanced stage uterine papillary serous carcinoma (UPSC). ^ METHODS: A retrospective review of patients diagnosed with stage III or IV UPSC between 1993 and 2012 was performed. Summary statistics were used to identify treatment related differences in demographic and clinical characteristics. OS and RFS were estimated with the Kaplan-Meier estimator and Cumulative Incidence Function respectively. Cox proportional hazard and sub distributional hazard (SDH) regression models were used to model the association of potential prognostic factors with OS and RFS respectively, where SDH adjusted for competing risks. ^ RESULTS: The study included 260 patients with median follow-up of 26.6 months (range 1-172.8). Median age was 63 years (range 30-88) and 67.7% were Caucasians. The complete response (CR) rate was 68.9%, and the recurrence rate was 82.7%. Treatment modality, histology, stage, and platinum sensitivity were significantly associated with OS in univariate analysis. In multivariate analysis, treatment modality, histology, and stage were significantly associated with OS. Treatment modality, body mass index (BMI), stage, platinum sensitivity, and type of chemotherapy were significantly associated with RFS with univariate analysis. Only stage was significantly associated with RFS with multivariate analysis, while treatment modality only approached significance. ^ CONCLUSIONS: Patients with advanced stage UPSC have a poor prognosis, regardless of treatment received. Combination therapy that includes surgery and earlier stage are significantly associated with OS in these women.^
Pal, Navdeep, "Factors prognostic of survival in advanced stage uterine papillary serous carcinoma" (2015). Texas Medical Center Dissertations (via ProQuest). AAI10126671.