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Uterine Papillary Serous Carcinoma Arising in a Polyp

A Multicenter Retrospective Analysis on 75 Patients

Mandato, Vincenzo D., MD, PhD*; Torricelli, Federica, Bsc; Palomba, Stefano, MD*; Uccella, Stefano, MD, PhD‡,§; Pirillo, Debora, MD*; Ciarlini, Gino, MD; De Iaco, Pierandrea, MD; Lucia, Emilio, MD#; Giorda, Giorgio, MD#; Ditto, Antonino, MD**; Ghezzi, Fabio, MD; Sanseverino, Francesca, MD††; Franchi, Massimo, MD‡‡; Bifulco, Giuseppe, MD§§; Mastrofilippo, Valentina, MD; Abrate, Martino, MD; Aguzzoli, Lorenzo, MD; La Sala, Giovanni B., MD*

American Journal of Clinical Oncology: May 2019 - Volume 42 - Issue 5 - p 472–480
doi: 10.1097/COC.0000000000000541
Original Articles: Gynecologic
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Objectives: The objectives of this study were to evaluate whether the international recommendations on the management of uterine papillary serous carcinoma arising in a polyp are uniformly followed in Italian Oncologic Centers and whether the strategy adopted is effective.

Materials and Methods: Patients with uterine papillary serous carcinoma arising in a polyp and who had undergone a hysterectomy were identified in the 2003-2013 database of 7 Italian Gynecologic Oncology Centers. Clinical and pathologic characteristics and outcomes were compared between staging procedure types. Survival curves of the women were plotted using the Kaplan-Meier method and analyzed using Cox regression hazard model and the log-rank test. Associations between clinical parameters and the incidence of recurrence were assessed by generalized linear models and the Fisher test.

Results: A total of 75 patients met the inclusion criteria. Recurrence-free survival was affected positively by type of surgical staging and negatively by preoperative diagnosis of hypertension. The association between surgical staging and recurrence-free survival resulted significant at univariate survival analysis (P=0.048 and 0.045) and maintained a trend of significance (P=0.070) in multivariate analysis, whereas hypertension was demonstrated to be the principal influencing factor.

Conclusions: The international recommendations on the management of uterine papillary serous carcinoma are not uniformly followed in daily practice, although the extension of the surgery seems to be associated with lower recurrence rates also when uterine papillary serous carcinoma is confined to a polyp or endometrial surface.

*Unit of Obstetrics and Gynecology, Azienda USL-IRCCS of Reggio Emilia

Laboratory of Translational Research, Azienda USL-IRCCS of Reggio Emilia

Unit of Surgical Gynecol Oncology, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia

Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese

§Department of Woman and Child Health, Policlinico Universitario A. Gemelli, IRCCS, Roma

Unit of Gynecologic Oncology, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna

#Unit of Gynecologic Oncology, Centro di Riferimento Oncologico (CRO) of Aviano —National Cancer Institute, Aviano

**Unit of Gynecologic Oncology, National Cancer Institute of Milan—IRCCS, Milan

††Unit of Gynecologic Oncology, Centro di Riferimento Oncologico della Basilicata (CROB) of Rionero in Vulture—IRCCS, Vulture

‡‡Department of Obstetrics and Gynecology, University of Verona, Verona

§§Department of Obstetrics and Gynecology, University of Naples Federico II, Naples, Italy

The authors declare no conflicts of interest.

Reprints: Vincenzo D. Mandato, MD, PhD, Unit of Obstetrics and Gynecology, Azienda USL-IRCCS of Reggio Emilia, Viale Risorgimento n 80, Reggio Emilia 42121, Italy. E-mail: dariomandato@gmail.com.

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