Background: Uterine serous carcinoma is a rare histologic subtype of endometrial cancer. Oncologic outcomes for this disease are sparsely reported, and adjuvant therapy after surgery is considerably heterogeneous.

Objective: To determine the 2-year recurrence rate, recurrence-free survival, overall survival, and associated factors among patients with uterine serous carcinoma after surgical treatment at Siriraj Hospital.

Materials and Methods: One hundred thirty uterine serous carcinoma patients diagnosed between December 2007 and June 2015 were enrolled. Patients who did not undergo surgery as a primary treatment or not achieve clinically complete response were excluded. Pathological slides were reviewed. Data were retrieved from the medical records including gynecologic data, surgical and pathological results, post-operative treatment, response status, recurrence status, and follow-up data. The recurrence rate at two years was calculated. Recurrence-free survival and overall survival were analyzed, and various characteristics were used to determine associated treatment outcomes.

Results: One hundred nine patients were analyzed, 50 in stage I, 15 in stage II, 38 in stage III, and six in stage IV. Median followup time was 23 months. At two years, the recurrence rate was 35.8%. Post-operative treatment was performed in 91.7%, and chemotherapy was the most common modality used. Eleven patients (16.9%) in early-stage and twenty-five patients (56.8%) in the advanced stage had disease recurrence. Thirty patients (83.3%) had disease recurrence intra-abdominal or multiple metastases. No patient in stage I that received adjuvant chemotherapy had relapsed disease. Two-year recurrence-free survival and 2-year overall survival were 71.2% and 83.4%, respectively. FIGO staging was the only factor associated with recurrencefree survival.

Conclusion: Uterine serous carcinoma represents a rare disease with a high recurrence rate and poor prognosis. FIGO staging is related to recurrence-free survival. Adjuvant chemotherapy showed survival benefits in early-stage uterine serous carcinoma.

Keywords: Uterine serous carcinoma, Adjuvant therapy, Recurrence, Survival

DOI: doi.org/10.35755/jmedassocthai.2020.10.11770

Received 14 August 2020 | Revised 29 September 2020 | Accepted 1 October 2020