Uterine XXXX : A Single-Institution Review of 62 Cases.

@entity1204 @entity1377 @entity1
OBJECTIVE: Uterine @entity1377 (UPSC) is a rare variant of @entity1204 responsible for up to 40% of @entity1204 . Controversy remains regarding optimal adjuvant therapy for UPSC, with lack of randomized trials to date. The objective of this retrospective study was to evaluate clinicopathological factors and determine event-free survival and overall survival (OS) in @entity1 with UPSC managed within a single institution. MATERIALS AND METHODS: Medical and pathological records between 1987 and 2004 were reviewed at the Royal @entity1 's Hospital, Melbourne, Australia. Cox regression analysis was used to analyze effects of clinical and histopathological variables on @entity1 survival and survival times following adjuvant therapy. Event-free survival and OS were analyzed using the Kaplan-Meier survival curve. RESULTS: Sixty-two @entity1 were included; 96.8% were managed surgically and 56.5% were completely surgically staged. Myoinvasion was present in 72.6% (n = 45) of the @entity1 .In @entity1 with stage I disease, recurrence rate was 41.4% with a 5-year OS of 46%. In stage II, recurrence rate was 20% with a 5-year OS of 67%. In stage III, recurrence rate was 58.8% with a 5-year OS of 34%. In stage IV, recurrence rate was 71.4% with a 5-year OS of 29%.There was no significant difference in survival based on the presence of positive peritoneal cytology, positive lymphovascular space invasion or positive lymph nodes at diagnosis, and no significant difference in survival based on the type of adjuvant therapy administered. Depth of myometrial invasion was a significant determinant of poor prognosis (P = 0.027). CONCLUSIONS: Uterine @entity1377 is an aggressive variant of @entity1204 associated with a high proportion of advanced-stage disease at diagnosis, high recurrence rates, and low OS. In our @entity1 , prognosis was determined by myometrial invasion and International Federation of Gynecology and Obstetrics stage at diagnosis. Randomized trials in this area are required to clarify optimal adjuvant therapy for @entity1 with UPSC.
