Surgical Cytoreduction In Advanced Stage Serous Endometrial Carcinoma

Objectives To evaluate oncologic outcomes in patients with advanced-stage serous endometrial cancer treated with upfront surgical cytoreduction. Methods We retrospectively identified patients with newly diagnosed Stage III or IV serous endometrial cancer treated with upfront surgery from 1/2005–12/2015. Patients treated with upfront chemotherapy (CT) were excluded. Appropriate statistics were performed. Results 169 pts were included; 97(57%) Stage III, 72 (43%) Stage IV. 108 (64%) underwent open surgery, 61(36%) minimally invasive surgery. All had hysterectomy/bilateral adnexectomy: 53 (31%) upper and lower abdominal resections (liver, diaphragm, bowel, etc), 116 (69%) only omental and nodal resections. 120 (71%) had 0mm residual, 38 (23%) 1–10mm residual, 11 (7%) >10mm residual disease. 160 (95%) received post-operative therapy (POT): 93(55%) CT alone, 66 (39%) both CT and radiotherapy. Overall, age, race, BMI, and histologic subtype were comparable (table 1). Median follow-up for survivors is 56 mos (range: 0.5–137). Using multivariate analysis considering interaction of residual disease with stage, there was no statistically significant PFS or OS advantage based on residual disease status. Wash status was associated with improved PFS; age, wash status, and POT were associated with improved OS. Conclusions Upfront surgical cytoreduction was not associated with improved PFS or OS regardless of residual disease status in advanced-stage serous endometrial cancer. A collaborative effort to evaluate the impact of 0mm residual on oncologic outcomes is underway.