Stage I Clear Cell and Serous Uterine Carcinoma: What Is the Right Adjuvant Therapy?

Curr Oncol. 2023 Jan 14;30(1):1174-1185. doi: 10.3390/curroncol30010090.

Abstract

This single-center study aimed to retrospectively evaluate the survival outcomes of patients with FIGO stage I clear cell and serous uterine carcinoma according to the type of adjuvant treatment received. The data were collected between 2003 and 2020 and only patients with stage I clear cell or serous uterine carcinoma treated with primary surgery were included. These were classified into three groups: No treatment or brachytherapy only (G1), radiotherapy +/- brachytherapy (G2), chemotherapy +/- radiotherapy +/- brachytherapy (G3). In total, we included 52 patients: 18 patients in G1, 16 in G2, and 18 in G3. Patients in the G3 group presented with poorer prognostic factors: 83.3% had serous histology, 27.8% LVSI, and 27.8% were FIGO stage IB. Patients treated with adjuvant radiotherapy showed an improved 5-year overall survival (OS) (p = 0.02) and a trend towards an enhanced 5-year progression-free survival (PFS) (p = 0.056). In contrast, OS (p = 0.97) and PFS (p = 0.84) in the chemotherapy group with poorer prognostic factors, were similar with increased toxicity (83.3%). Radiotherapy is associated with improved 5-year OS and tends to improve 5-year PFS in women with stage I clear cell and serous uterine carcinoma. Additional chemotherapy should be cautiously considered in serous carcinoma cases presenting poor histological prognostic factors.

Keywords: clear cell uterine carcinoma; serous uterine carcinoma; stage I; survival; toxicities.

MeSH terms

  • Adenocarcinoma, Clear Cell* / pathology
  • Adenocarcinoma, Clear Cell* / surgery
  • Chemotherapy, Adjuvant
  • Cystadenocarcinoma, Serous* / pathology
  • Cystadenocarcinoma, Serous* / surgery
  • Female
  • Humans
  • Hysterectomy
  • Neoplasm Staging
  • Retrospective Studies
  • Uterine Neoplasms* / surgery

Grants and funding

This research received no external funding.