**4.9 Papillary serous carcinoma and clear cell carcinoma**

Papillary serous and clear cell carcinoma require total hysterectomy, bilateral salpingoophorectomy, pelvic and paraaortic lymphadenectomy, omentectomy, appendectomy and peritoneal biopsies. There is more aggressiveness with higher rates of metastatic disease and lower 5-year survival rates. The same chemotherapy regimens usually used for ovarian cancer could be also used in women with advanced or recurrent papillary serous or clear cell uterine cancer. Papillary serous endometrial carcinomas have not been considered to be hormone responsive [Colombo, 2011].
