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      저자 : Christina Isacson (검색결과 1 건)
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        An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers

        Tilley Jenkins Vogel,Abhay Knickerbocker,Chirag A. Shah,Melissa A. Schiff,Christina Isacson,Rochelle L. Garcia,Barbara A. Goff 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.1

        Objective: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), theycontribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis islacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiarycare cancer centers. Methods: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their associationwith overall survival (OS) and progression-free survival (PFS). Results: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patientspresented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0%and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68;95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improvedOS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS basedon the performance of a paraaoritc lymph node dissection. Conclusion: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC andwas not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.

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