TY - JOUR
T1 - Clinicopathologic features and treatment in patients with early stage uterine clear cell carcinoma
T2 - A 16-year experience
AU - Armbruster, Shannon D.
AU - Previs, Rebecca
AU - Soliman, Pamela T.
AU - Westin, Shannon N.
AU - Fellman, B.
AU - Jhingran, A.
AU - Fleming, Nicole D.
N1 - Funding Information:
Supported by the NIH/NCI under award numbers 5T32 CA101642, NIH 2P50 CA098258-06, NIH P30CA016672, and Andrew Sabin Family Fellowship.
Funding Information:
Supported by the NIH / NCI under award numbers 5T32 CA101642 , NIH 2P50 CA098258-06 , NIH P30CA016672 , and Andrew Sabin Family Fellowship .
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/8
Y1 - 2019/8
N2 - 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). 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. 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. 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.
AB - 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). 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. 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. 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.
KW - Chemotherapy
KW - Clear cell carcinoma
KW - Endometrial cancer
KW - Radiation
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U2 - 10.1016/j.ygyno.2019.06.001
DO - 10.1016/j.ygyno.2019.06.001
M3 - Article
C2 - 31221496
AN - SCOPUS:85067305288
SN - 0090-8258
VL - 154
SP - 328
EP - 332
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -