Endometrial cancer: Part II. Multimodality treatment of uterine high-grade serous carcinoma (clinical course II)

The part II (clinical course I) of endometrial cancer (EC) describing the complex clinical course (initial treatment and therapy for the first recurrence at both local-regional and distant metastatic sites) of a 66-year-old woman with uterine high-grade serous carcinoma (HGSC, post-curettage diagnosis) after minimally invasive surgery (MIS) treatment-confirmed absence of residual tumor. In the clinical course I, we discussed the recent trend in using MIS for treating early-stage EC patients, regardless whether histologic types are classified, as well as the rationale of absent following postoperative adjuvant therapy due to no residual tumor of gross specimen after complete staging surgery. The patient had multiple recurrences at both loco-regional and distant sites after 22-month disease-free survival (DFS). After salvage therapy, including incomplete cytoreductive surgery for symptom control, chemotherapy, radiotherapy and final systemic therapy, the patient had a durable response period (10-month treatment plus 9 months of the 2nd progression-free survival [PFS]). The current report is the subsequent clinical course of this patient (clinical course II), which further managed this patient at the second recurrence based on multiple modality treatment to achieve the durable response and significantly improve the quality of life.