Clinical predictors of long-term survival for stage IVB uterine papillary serous carcinoma confined to the abdomen

• Long-term disease remission may be achieved in women with FIGO stage IVB UPSC confined to the abdomen
• Clinical predictors of long-term survival were optimal cytoreduction and platinum-based chemotherapy, while radiation therapy decreased rates of recurrence
• 5-year DFS and OS rates were 12% and 19%, and 5 of 48 patients were disease-free at 124 months

ObjectiveTo identify clinical predictors of long-term survival in women with FIGO Stage IVB uterine papillary serous carcinoma (UPSC) confined to the abdomenMethodsRecords were reviewed for 48 patients with Stage IVB UPSC diagnosed from 1/1980 to 12/2011. Study inclusion required hysterectomy, salpingo-oophorectomy and negative chest imaging. Disease-free (DFS) and overall (OS) survival rates were calculated using the Kaplan–Meier method. Multivariate analysis (MVA) was performed using Cox proportional hazards.ResultsMedian age at diagnosis was 70 years (range, 53–87). Optimal cytoreduction (Opt) to < 1 cm residual disease was performed in 36 patients (75%). With a median follow-up of 21 months for all patients and 99 months for survivors, 36 (75%) experienced disease progression or relapse, most commonly intraperitoneal (16, 44%). At 5 years, DFS and OS rates were 12% and 19%, respectively. Five patients (10%) were long-term survivors without relapse at a median of 124 months. All 5 had Opt and carboplatin/paclitaxel chemotherapy, and 4 received radiotherapy (2 pelvic, 1 whole-abdominal, 1 brachytherapy). On MVA in the chemotherapy-treated population, Opt (HR 0.09, 95% CI 0.02–0.35) and radiotherapy (HR 0.36, 0.15–0.80) were associated with decreased rates of recurrence or progression. Opt (HR 0.09, 0.02–0.38) was prognostic for OS when adjusted for age.ConclusionsClinical predictors of long-term survival for Stage IVB UPSC confined to the abdomen include optimal cytoreduction and adjuvant platinum and paclitaxel chemotherapy. Radiotherapy may decrease rates of recurrence or progression. Despite intra-abdominal involvement, disease remission and long-term survival may be achieved in some patients.