Preoperative Radiotherapy for Inoperable Stage II Endometrial Cancer: Insights into Improving Treatment and Outcomes

Lee, Marette; Aquino‐Parsons, Christina; Hoskins, Paul; Lim, Peter; Kwon, Janice S.

doi:10.1016/s1701-2163(15)30893-8

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…It is important to note that this is the largest multi-institutional, retrospective study of stage II endometrial cancer using the 2009 FIGO staging system [6]. Previous retrospective stage II studies were predominantly performed using the 1988 FIGO staging system.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis of endometrial cancer patients with cervical stromal involvement

et al. 2014

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ObjectiveStage II endometrial cancer is relatively uncommon. There is no consensus for appropriate adjuvant therapy in endometrial cancer patients with cervical stromal involvement (International Federation of Gynecology and Obstetrics [FIGO] stage II). This study investigates how adjuvant treatments and tumor characteristics influence overall survival (OS) and disease-free survival (DFS) in stage II patients in order to establish better treatment guidelines.MethodsThis multi-institution, Institutional Review Board approved, study is a retrospective review of 40 endometrial cancer patients with cervical stromal involvement treated from 1993 to 2009. Kaplan-Meier estimates were used to evaluate OS and DFS.ResultsOS was 85% at three years and 67% at five years. There were no significant differences in age, histology, depth of invasion, comorbid conditions, surgical staging or recurrence between patients who received radiation therapy (RT) and those who did not. However, patients with FIGO grade 1 cancers were less likely to receive RT (p=0.007). Patients treated with RT had a similar 5 year OS (n=33, 69%) to those treated with surgery only (n=7, 60%, p=0.746). There were no OS differences when evaluating by grade, histology, or depth of invasion between patients who did and did not receive RT. Four patients recurred: three were locoregional failures only, and one failed locally and distant.ConclusionPatients receiving RT had higher grade tumors. Despite this, OS was comparable between the RT and the no RT cohorts. Local failure was the predominant pattern of failure. Endometrial cancer patients with cervical stromal involvement likely receive better locoregional control with the addition of adjuvant RT and we continue to advocate for RT in most cases.

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Section: Discussionmentioning

confidence: 99%

Survival analysis of endometrial cancer patients with cervical stromal involvement

et al. 2014

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“…However, neoadjuvant therapy followed by a less extensive simple hysterectomy can represent an alternative. If surgery is not considered feasible because of tumor extension and/or in medically inoperable patients, full pelvic radiotherapy and intracavitary brachytherapy, as in cervical cancer, may be employed either preoperatively or definitively with high disease control and survival rates …”

Section: Stage IImentioning

confidence: 99%

Cancer of the corpus uteri

Amant

Mirza

Koskas³

et al. 2018

Intl J Gynecology & Obste

331

231

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Endometrial cancer is the most common gynecological malignancy in high‐income countries. Although the overall prognosis is relatively good, high‐grade endometrial cancers have a tendency to recur. Recurrence needs to be prevented since the prognosis for recurrent endometrial cancer is dismal. Treatment tailored to tumor biology is the optimal strategy to balance treatment efficacy against toxicity. Standard treatment consists of hysterectomy and bilateral salpingo‐oophorectomy. Lymphadenectomy (with ongoing studies of sentinel node biopsy) enables identification of lymph node positive patients who need adjuvant treatment, including radiotherapy and chemotherapy. Adjuvant radiotherapy is used for Stage I–II patients with high‐risk factors and Stage III lymph node negative patients. In advanced disease, a combination of surgery to no residual disease and chemotherapy results in the best outcome. Surgery for recurrent disease is only advocated in patients with a good performance status with a relatively long disease‐free interval.

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Endometrial Cancer

Creutzberg¹,

Fleming²

2016

Clinical Radiation Oncology

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Preoperative Radiotherapy for Inoperable Stage II Endometrial Cancer: Insights into Improving Treatment and Outcomes

Cited by 4 publications

References 24 publications

Survival analysis of endometrial cancer patients with cervical stromal involvement

Survival analysis of endometrial cancer patients with cervical stromal involvement

Cancer of the corpus uteri

Endometrial Cancer

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