Yale Procedure Cuts Recurrence Of Aggressive Uterine Cancer
- Date:
- September 26, 2005
- Source:
- Yale University
- Summary:
- A state-of-the-art treatment program developed at Yale School of Medicine increases survival from the aggressive uterine papillary serous carcinoma (UPSC) and spares some patients the need for additional therapy.
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New Haven, Conn. - A state-of-the-art treatment programdeveloped at Yale School of Medicine increases survival from theaggressive uterine papillary serous carcinoma (UPSC) and spares somepatients the need for additional therapy.
The results are presented in the lead article of September'sGynecologic Oncology. The research team, led by senior author PeterE. Schwartz, M.D., The John Slade Ely Professor and Vice Chairman ofthe Department of Obstetrics, Gynecology & Reproductive Sciences,determined that a combination of platinum-based chemotherapy andvaginal radiation was the most effective treatment for the disease.
"Our study defines a standard of care for this aggressive and growingform of uterine cancer," said Schwartz, who is also assistant chiefof obstetrics and gynecology at Yale-New Haven Hospital. Theprocedure more accurately determines the complete stage andappropriate treatment and reduces the recurrence of the cancer.
The incidence of UPSC has increased since it was first identified in1981. About 160 to 170 new cases of uterine cancer per year are seenat Yale. About seven percent are UPSC. UPSC is found in higherrates in African American women than in white women. The diseasemicroscopically looks like ovarian cancer and spreads just as rapidly.
"Until now, there has been no consistent management of thedisease," said first author Michael G. Kelly, M.D., fellow andinstructor in the Department of Obstetrics, Gynecology & ReproductiveSciences at Yale. "With this method, we've been able to see who needsadditional treatment after surgery and who does not. By reducingrecurrence, we are helping to increase the survival rates of womenwith this form of uterine cancer. Once the disease recurs, virtuallyno one is cured."
The team reviewed 74 stage one patients with UPSC whounderwent complete surgical staging, or hysterectomy with removal ofpelvic and para-aortic lymph nodes and fat pads, at Yale between 1987and 2004. Cancer recurred in 43 percent of early stage patients whodid not receive chemotherapy, while in the 20 percent of patients whoreceived platinum-based chemotherapy there were no recurrences. About14 patients were spared additional radiation treatment.
Other authors included David M. O'Malley, Pei Hui, Jessica McAlpine,M.D., Herbert Yu, M.D., Thomas J. Rutherford, M.D., and Masoud Azodi,M.D.
Citation: Gynecologic Oncology, Volume 98, Issue 3, September 2005, 341-343
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