Adjuvant therapy for endometrial cancer

Abstract

Endometrial cancer is a common gynecologic malignancy typically diagnosed at early stage and cured with surgery alone. Adjuvant therapy is tailored according to the risk of recurrence, estimated based on the International Federation of Gynecology and Obstetrics (FIGO) stage and other histological factors. The objective of this manuscript is to review the evidence guiding adjuvant therapy for early stage and locally advanced uterine cancer. For patients with early stage disease, minimizing toxicity, while preserving outstanding cure rates remains the major goal. For patients with locally advanced endometrial cancer optimal combined regimens are being defined. Risk stratification based on molecular traits is under development and may aid refine the current risk prediction model and permit personalized approaches for women with endometrial cancer.

Survival outcome in endometrial cancer patients according to hereditary predisposition

“…Increased sensitivity to chemotherapy is one of the explanations provided for the better survival rate of ovarian cancer patients with a familial history of ovarian cancer/breast cancer [8]. Unlike ovarian cancer, most endometrial cancers are diagnosed in the early stages and adjuvant treatments are restrictively performed [16,17]. The exact reason for the lower survival outcome in patients with endometrial cancer with a hereditary predisposition was difficult to identify in this study because of the limited number of cases and study design.…”

Impact of adjuvant radiotherapy on the survival of women with optimally resected stage III endometrial cancer in the era of modern radiotherapy: a retrospective study

“…Approximately one-fifth of the patients are diagnosed at an already advanced stage; the 5-year overall survival (OS) rates of those with stage III disease who are able to undergo optimal resection are 70-80% when adjuvant therapy is administered and 30-40% when it is not [2,3]. The most suitable adjuvant treatment for stage III endometrial cancer remains undefined, including the appropriate adjuvant chemotherapy, radiotherapy, or combined chemoradiotherapy options [4][5][6][7]; notably, only a few prospective studies on this topic have been performed [8,9].…”

Difference in Practice Patterns in the Management of Endometrial Cancer: A Survey of the Members of 4 East Asian Gynecologic Oncology Groups

“…However, the role of CCRT has not been determined, and several ongoing trials are currently investigating whether chemotherapy improves survival in endometrial cancer. 22 Specifically, the GOG 249 and PORTEC-3 trials are comparing WPRT versus CCRT in early-stage endometrial cancer, whereas the GOG 258 trial is comparing CCRT versus chemotherapy in advanced-stage endometrial cancer.…”