Combined modality therapy in the adjuvant treatment of uterine serous carcinoma

Uterine serous carcinoma (USC) represents a clinically aggressive and highly malignant endometrial cancer. Initially distinguished from other types of primary endometrial adenocarcinoma in 1982, Hendrickson et al. [1] performed a pathologic review of 256 stage I endometrial cancers treated at Stanford University, with 26 of the cases revealing USC. Of these cases, 40% had deep myometrial invasion compared to 12% of typical adenocarcinomas. With deep invasion, relapse rates for USC were 63% compared to only 30% for adenocarcinomas. As a whole, 50% of the USC patients recurred, with most recurrences occurring on peritoneal surfaces in the upper abdomen. The authors concluded that this type of pattern of spread was similar to ovarian cancer and should be treated as such with either upper abdominal and pelvic radiotherapy or chemotherapy [1].