Uterine papillary serous carcinoma--the KK Hospital experience

A review of 355 cases of endometrial cancer treated at the KK Gynaecological Cancer Centre from June 1987 to June 1997 revealed 19 cases (5.3%) of uterine papillary serous carcinoma (UPSC), a clinically aggressive and pathologically distinct variant of adenocarcinoma which closely resembles ovarian papillary serous carcinoma. The majority of UPSC presented as late stage disease with 79% showing extrauterine disease. Twelve of 15 patients also had lymphovascular space invasion. Of the 19 cases, 15 had total hysterectomy and bilateral salpingo-oophorectomy with or without omentectomy and lymphadenectomy. Two had omental biopsy only and another 2 had dilatation and curettage only. The overall median survival in the series was 15 months. Twelve patients had died of disease (67%). Early stage disease seemed to confer a better prognosis. The poor prognosis is frequently ascribed to its tendency to present at a late stage.