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Journal article
The role of adjuvant treatment for early-stage uterine clear cell carcinomas
Gynecologic oncology, v 170, pp 77-83
01 Mar 2023
PMID: 36641903
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Uterine clear cell carcinoma is a rare and aggressive subtype of endometrial carcinoma. Prospective clinical trials have not been feasible for this rare tumor, and data regarding the optimal adjuvant treatment regimen for early-stage uterine clear cell carcinomas is limited. Our study's objective was to determine if adjuvant chemotherapy or radiation therapy improves patients' outcomes in stage I and II uterine clear cell carcinoma.
Patients with stage I and II uterine clear cell carcinoma were identified at a single institution. All cases were reviewed by a gynecologic pathologist. Both pure and mixed non-serous uterine clear cell carcinomas were included. Primary outcomes were recurrence free survival and overall survival.
A total of 71 patients were identified including 39 (55%) pure and 32 (45%) mixed clear cell carcinoma. Most patients were FIGO stage IA (77.5%). Most patients (n = 58, 82%) received adjuvant therapy, including 43 (61%) receiving chemotherapy, 50 (70%) receiving radiation therapy, and 35 (49%) receiving both. Recurrence free survival was not significantly different among patients receiving no or <6 cycles of chemotherapy versus patients receiving 6 cycles of chemotherapy (p = 0.39). However, median OS was significantly different among patients receiving no or <6 cycles of chemotherapy versus 6 cycles of chemotherapy (p = 0.004). On univariable analysis, 6 cycles of chemotherapy was significantly associated with improved OS (HR 0.1, 95% CI 0.01–0.07). Presence of LVSI, mutated p53, number of pelvic and para-aortic lymph nodes assessed, adjuvant chemotherapy (any number of cycles), and >2 medical co-morbidities were not significant predictors of OS on univariable analysis. On multivariable analysis, 6 cycles of adjuvant chemotherapy remained a significant predictor of improved OS (HR 0.1, 95% CI 0.01–0.8).
In this study, administration of 6 cycles of chemotherapy appears to significantly improve OS. This finding suggests consideration of 6 cycles of adjuvant chemotherapy in patients with early-stage uterine clear cell carcinoma, however clinical trials are needed to confirm these findings.
•Pathologic confirmation of pure or mixed uterine clear cell carcinoma was performed for each patient.•Receipt of adjuvant therapy was not associated with improvements in RFS.•Receipt of a full 6 cycles of adjuvant chemotherapy was associated with improved OS in this cohort.
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Details
- Title
- The role of adjuvant treatment for early-stage uterine clear cell carcinomas
- Creators
- T.J. Orellana - Magee-Womens HospitalA.A. Garrett - Magee-Womens HospitalT.R. Soong - Magee-Womens HospitalT. Rives - Magee-Womens HospitalM. Courtney-Brooks - Magee-Womens HospitalS.E. Taylor - Magee-Womens HospitalJ. Lesnock - Magee-Womens HospitalJ. Berger - Magee-Womens HospitalM. Boisen - Magee-Womens HospitalL. Coffman - Magee-Womens HospitalR. Buckanovich - Magee-Womens HospitalH. Mahdi - Magee-Womens HospitalJ.C. Comerci - Magee-Womens HospitalS. Beriwal - Allegheny Health NetworkP. Sukumvanich - Magee-Womens HospitalR.P. Edwards - Magee-Womens HospitalR. Bhargava - Magee-Womens HospitalA.B. Olawaiye - Magee-Womens Hospital
- Publication Details
- Gynecologic oncology, v 170, pp 77-83
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000923155300001
- Scopus ID
- 2-s2.0-85146309751
- Other Identifier
- 991021897391904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Obstetrics & Gynecology
- Oncology