To investigate the prognostic factors of stage Ⅰ uterine serous carcinoma (USC), and help to plan the postoperative adjuvant treatment.

We retrospectively analyzed the clinicopathological features, treatment and prognosis of stage Ⅰ USC patients in our hospital between 2009 and 2018.

A total of 67 patients were enrolled and 56 cases were followed up. 36 cases (64.3%) were in stage Ⅰ_A, and 20 cases (35.7%) were in stage Ⅰ_B; 21 cases (37.5%)were USC, and 35 cases (62.5%) were mixed carcinoma with USC. The median follow-up time was 132.7 months. 6 patients had recurrence, and 5 patients died. There were statistically significant differences in FIGO stage, tumor grade, depth of myometrial invasion, height and weight between recurrence group and non-recurrence group (P<0.05); in stage Ⅰ_B, there were significant differences in postoperative adjuvant therapy, CA125 value before treatment, height and weight between recurrence group and non-recurrence group (P<0.05). Univariate analysis showed that height, weight, body mass index (BMI) and CA125 value before treatment were correlated with prognosis(P<0.05).

USC is highly malignant in biological behavior, so even for stage Ⅰ_A patients, we suggest postoperative chemotherapy to prevent distant metastasis, and the benefit of radiotherapy is still controversial; for stage IB, chemotherapy combined with radiotherapy may reduce the recurrence rate. Small body size and CA125>43 U/ml before treatment are associated with worse prognosis, so they may be used as risk factors for early stage of USC to guide the postoperative adjuvant treatment.

Uterine serous carcinoma; Biological characteristics; Prognosis