Adjuvant sequential chemo and radiotherapy improves the oncological outcome in high risk endometrial cancer.
10.3802/jgo.2015.26.4.284
- Author:
Mauro SIGNORELLI
1
;
Andrea Alberto LISSONI
;
Elena DE PONTI
;
Tommaso GRASSI
;
Serena PONTI
;
Robert FRUSCIO
Author Information
1. Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy. robert.fruscio@unimib.it
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Endometrial Neoplasms;
Lymph Node Excision;
Multivariate Analysis;
Retrospective Studies;
Survival rate
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Chemoradiotherapy/*methods;
Chemotherapy, Adjuvant/methods;
Endometrial Neoplasms/*therapy;
Female;
Humans;
Laparoscopy/methods;
Lymph Node Excision/methods;
Lymphatic Metastasis;
Middle Aged;
Radiotherapy, Adjuvant/methods;
Retrospective Studies;
Risk Factors;
Treatment Outcome;
Young Adult
- From:Journal of Gynecologic Oncology
2015;26(4):284-292
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Evaluation of the impact of sequential chemoradiotherapy in high risk endometrial cancer (EC). METHODS: Two hundred fifty-four women with stage IB grade 3, II and III EC (2009 FIGO staging), were included in this retrospective study. RESULTS: Stage I, II, and III was 24%, 28.7%, and 47.3%, respectively. Grade 3 tumor was 53.2% and 71.3% had deep myometrial invasion. One hundred sixty-five women (65%) underwent pelvic (+/- aortic) lymphadenectomy and 58 (22.8%) had nodal metastases. Ninety-eight women (38.6%) underwent radiotherapy, 59 (23.2%) chemotherapy, 42 (16.5%) sequential chemoradiotherapy, and 55 (21.7%) were only observed. After a median follow-up of 101 months, 78 women (30.7%) relapsed and 91 women (35.8%) died. Sequential chemoradiotherapy improved survival rates in women who did not undergo nodal evaluation (disease-free survival [DFS], p=0.040; overall survival [OS], p=0.024) or pelvic (+/- aortic) lymphadenectomy (DFS, p=0.008; OS, p=0.021). Sequential chemoradiotherapy improved both DFS (p=0.015) and OS (p=0.014) in stage III, while only a trend was found for DFS (p=0.210) and OS (p=0.102) in stage I-II EC. In the multivariate analysis, only age (< or =65 years) and sequential chemoradiotherapy were statistically related to the prognosis. CONCLUSION: Sequential chemoradiotherapy improves survival rates in high risk EC compared with chemotherapy or radiotherapy alone, in particular in stage III.
