Conditional estimates for uterine serous cancer: Tools for survivorship counseling and planning

Angela C. Nolin, Chunqiao Tian, Chad A. Hamilton, Yovanni Casablanca, Nicholas W. Bateman, John K. Chan, Michele L. Cote, Craig D. Shriver, Matthew A. Powell, Neil T. Phippen, Thomas P. Conrads, G. Larry Maxwell, Kathleen M. Darcy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: Develop conditional survival and risk-assessment estimates for uterine serous carcinoma (USC) overall and stratified by stage as tools for annual survivorship counseling and care planning. Methods: Patients in the National Cancer Data Base diagnosed between 2004 and 2014 with stage I-IV USC were eligible. Individuals missing stage or survival data or with multiple malignancies were excluded. Five-year conditional survival was estimated using the stage-stratified Kaplan-Meier method annually during follow-up. A standardized mortality ratio (SMR) estimated the proportion of observed to expected deaths in the U.S. adjusted for year, age, and race. The relationships between prognostic factors and survival were studied using multivariate Cox modeling at diagnosis and conditioned on surviving 5-years. Results: There were 14,575 participants, including 43% with stage I, 8% with stage II, 29% with stage III, and 20% with stage IV USC. Five-year survival at diagnosis vs. after surviving 5-years was 52% vs. 75% overall, 77% vs. 81% for stage I, 57% vs. 72% for stage II, 40% vs. 66% for stage III, and 17% vs. 60% for stage IV USC, respectively (P < 0.0001). Incremental improvements in 5-year conditional survival and reductions in SMR tracked with annual follow-up and higher stage. The adjusted risk of death at diagnosis vs. after surviving 5-years was 1.15 vs. 1.40 per 5-year increase of age, 1.26 vs. 1.68 for Medicaid insurance, 3.92 vs. 2.48 for stage III disease, and 6.65 vs. 2.79 for stage IV disease, respectively (P < 0.0001). Conclusion: In USC, the evolution of conditional survival permits annual reassessments of prognosis to tailor survivorship counseling and care planning.

Original languageEnglish
Pages (from-to)90-99
Number of pages10
JournalGynecologic Oncology
Issue number1
StatePublished - Jul 2022
Externally publishedYes


  • Conditional survival
  • Endometrial cancer
  • NCDB
  • Standardized mortality risk
  • Survivorship
  • Uterine serous carcinoma


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