306P - Adjuvant treatment and impact on relapse in stage IA uterine papillary serous and clear cell carcinomas: A single center retrospective study

Background

Optimal adjuvant treatment for stage IA uterine papillary serous (UPSC) or clear cell carcinomas (UCCC) remains unknown. Options include no adjuvant treatment or systemic chemotherapy, Pelvic RT and Vaginal brachytherapy alone or in combination. These subtypes represent an infrequent set of patients, and hence there is lack of randomized trial data to guide optimal management. The aim of this study was to evaluate treatment patterns and relapse characteristics in this uncommon subtype based on the retrospective data from a single centre.

Methods

Clinicopathologic data, treatment patterns and relapse characteristics were retrospectively collected on patients of UPSC and UCCC treated between January 2014 and December 2018. Adjuvant treatment modalities used and their impact on relapse rates was analysed.

Results

We identified 21 patients who had undergone hysterectomy with bilateral salpingo-oophorectomy and were found to have stage 1A papillary serous or clear cell endometrial carcinoma. Nearly all patients (n-18, 85%) also underwent extended lymph node dissection of pelvic and para-aortic lymph nodes.

Median age at diagnosis was 61 years. Eighteen patients had uterine papillary serous carcinoma and three patients had clear cell histology. Eleven patients (52%) received systemic chemotherapy (six cycles of Paclitaxel and Carboplatin) with RT. and two patients received EBRT with or without VBT. Eight patients had no adjuvant treatment. At a median follow-up thirty months (range 6-63 months), six patient had experienced recurrences (28%). Nearly all the recurrences (n = 4) were in patients who received no adjuvant therapy with a relapse rate of 50% (4/8) in this subset. Four recurrences were distant metastasis while two were loco regional. At the time of last follow up, three patients with relapse had succumbed to their disease.

Conclusions

UPSC and UCCC are a distinct subtype of endometrial cancer and associated with an aggressive phenotype and high relapse rate even in patients with early stage. Systemic chemotherapy and Pelvic RT alone or in combination should always be considered in this group.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.