Uterine Papillary Serous Carcinoma—Still an Enigma?

Purpose Uterine papillary serous carcinoma (UPSC) accounts for 10–15% of all endometrial carcinomas. Poor outcome is because of higher stage at presentation and relapse in the upper abdomen. The purpose of this study was to analyse clinical and surgico-pathological features of UPSC. Methods Data was retrieved from medical records of patients with UPSC between March 2013 and August 2016. Patients underwent surgical staging or received neoadjuvant chemotherapy (NACT) in inoperable cases. Myometrial invasion (MI), lymphovascular invasion (LVSI) and metastases to lymph nodes were noted. Patients were staged according to FIGO 2009. Adjuvant chemotherapy (paclitaxel, carboplatin and epirubicin) with or without adjuvant radiotherapy was given. Survival was noted on follow-up. Results Ten patients were identified with UPSC. Complete surgical staging in five of ten and NACT in two patients were given. FIGO stage IA was observed in one patient and three each in IIIC2, IVB and stage unknown. MI of more than 50% in eight, LVSI in seven and lymph node metastases in five patients were seen. Adjuvant chemotherapy was received by nine and adjuvant radiotherapy in three patients. Two patients expired within 6 and 8 months after therapy. One patient had intra-abdominal recurrence 2 years after treatment. Conclusion Complete cytoreductive surgery followed by adjuvant platinum-/taxane-based chemotherapy with or without adjuvant radiotherapy should be the choice of treatment. Multi-centre collaborative studies are required in aiding treatment.