Clinical Analysis Of 14 Cases Of Uterine Papillary Serous Carcinoma

Objective:To investigate the clinical and pathological characteristics, the rational therapy and prognostic factors for the uterine papillary serous carcinoma(UPSC).Methods:Fourteen cases of UPSC were treated in our hospital between January 1999 and December 2008.The clinico-pathological characteristics, treatment and prognosis were retrospectively analyzed.Results:14 cases of UPSC accounted for 3.9% of carcinoma of uterine endometrium,their average age at diagnosis was 66 years,the most common symptom was irregular postmenopausal vaginal bleeding,the rate of diag-nosis in pre-operation was 46%.Of 14 cases,the early stage (stageâ… -â…¡) accounted for 43% ,while late stage (stageâ…¢-â…£) accounted for 57%,54% diagnosed as higher stage postoperatively than preoperative staging.Mean follow-up duration was 28 months,during follow-up,5 cases died,the 2-year survival rate for the early stage and late stage was 83.3% and 47.6%, respectively (P=0.042).Pure UPSC were seen in 64%,mixed were 36%,64% were G3,57% invaded more than half myometrium,43% had lymph-vascular space invasion (LVSI).All the patients underwent operation,5 cases received postoperative adjuvant radiotherapy,2 received postoperative adjuvant chemotherapy,2 received postoperative adjuvant radiotherapy and chemotherapy, postoperative adjuvant radiotherapy seems to improve the prognosis (P=0.028).The recurrent and distant metastasis rate was 38%,in analysis,FIGO stages (P=0.042),tumor cell differentiation (P=0.021),lymph node metastasis (P=0.032),LVSI (P=0.005) were associated with prognosis.Conclusion:UPSC is a special pathological type of endometrial carcinoma with highly aggressive behaviors and highly malignant,most UPSC patients are in late stages at diagnosis.They often have Poorly differentiated tumor cells and have a propensity for deeply myometrial invasion, extra-uterine spread and distant metastases. Many patients diagnosed as higher stage postoperatively than preoperative staging. They have a rather poor prognosis and a high rate of recurrence and metastases. FIGO stages, tumor cell differentiation,lymph node metastasis, LVSI are associated with prognosis. Complete surgical staging and maximal resection should be recommended, and postoperative adjuvant radiotherapy seems to improve the prognosis.