What is the role of chemotherapy in women with uterine papillary serous carcinoma or clear cell carcinoma?

The group unanimously endorsed the NCCN guidelines 2015 on the treatment of uterine papillary serous carcinoma or clear cell carcinoma. All the members agree that chemotherapy should be recommended for all stages of UPSC /Clear cell, including stage I disease.

In comparison with endometrioid adenocarcinomas, uterine serous and clear cell carcinomas are more aggressive histologic types and are considered high risk endometrial cancers. There is a paucity of data to help inform treatment recommendations for this group of patients, and they should be encouraged to participate in clinical trials. Most of the data on chemotherapy in these subtypes are largely retrospective or derived from randomized trials that included patients with all histologies. Treatment options include radiation therapy, adjuvant chemotherapy or a combined approach (chemotherapy plus radiation therapy). There is considerable evidence from retrospective series that platinum based adjuvant chemotherapy for early (stage 1 and II) disease improves PFS and OS.6,7Platinum-based chemotherapy is recommended in patients with stage III or IV. The same chemotherapy regimens usually employed for epithelial ovarian cancer can be considered in women with advanced or recurrent serous or clear-cell uterine cancer. Historically serous endometrial carcinomas have not been considered to be hormone responsive.