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Clinicopathologic features and treatment in patients with early stage uterine clear cell carcinoma: A 16-year experience.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2019 Aug; Vol. 154 (2), pp. 328-332. Date of Electronic Publication: 2019 Jun 18. - Publication Year :
- 2019
-
Abstract
- Objective: To evaluate clinicopathologic factors and adjuvant treatment effects on recurrence free (RFS) and overall survival (OS) in early stage uterine clear cell carcinoma (UCCC).<br />Methods: Our retrospective review included central pathology confirmed stage I or II UCCC treated and/or followed between 2000 and 2016. Cases with pure or mixed histology with >50% UCCC were included. Data were analyzed using Kaplan-Meier method and Cox proportional hazards regressions.<br />Results: 112 women were identified. Median age was 65.5 years (range 34-94). Most patients had mixed UCCC (61%), while 39% had pure UCCC. The majority of patients had stage IA UCCC (66%) versus stage IB (15%) or stage II (18%) disease. Adjuvant treatment included chemotherapy + radiation (26%), brachytherapy (27%), whole pelvic radiation (15%), chemotherapy alone (8%), and observation (24%). Thirty-eight (34%) women had recurrent disease. Median RFS was 4.32 years (95% CI 2.77-5.78). On multivariate analysis, age ≥70 (HR 2.48, 95% 1.28-4.81) and positive LVSI (HR 2.19, 95% CI 1.15-4.18) were associated with shorter RFS. Median OS was 9.8 years (95% CI 7.46-15.93). On multivariate analyses, age ≥70 (HR 3.57, 95% CI 1.64-7.74) and positive LVSI (HR 2.46, 95% CI 1.12-5.37) were associated with shorter OS. In this retrospective descriptive uncontrolled patient series, adjuvant treatment type did not impact RFS or OS.<br />Conclusions: OS approaches 10 years for early stage UCCC patients. Women ≥70 years have worse PFS and OS regardless of treatment modality, encouraging consideration of quality of life implications when electing for adjuvant therapy.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma, Clear Cell mortality
Adenocarcinoma, Clear Cell pathology
Adult
Age Factors
Aged
Aged, 80 and over
Brachytherapy
Chemoradiotherapy, Adjuvant
Chemotherapy, Adjuvant
Female
Humans
Kaplan-Meier Estimate
Longitudinal Studies
Middle Aged
Proportional Hazards Models
Radiotherapy, Adjuvant
Retrospective Studies
Uterine Neoplasms mortality
Uterine Neoplasms pathology
Watchful Waiting
Adenocarcinoma, Clear Cell therapy
Uterine Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 154
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31221496
- Full Text :
- https://doi.org/10.1016/j.ygyno.2019.06.001