Chemotherapy as Adjuvant Treatment for Early Stage Endometrial Cancer With High Intermediate Risk Factors

Gao, Min; Zhang, Naiyi; Song, Nan; Zheng, Hong; Yan, Xin; Gao, Yunong

doi:10.1097/igc.0000000000001295

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Te data suggested that women gain little beneft from adjuvant chemotherapy, including women with high-risk factors, such as deep myometrial invasion and the serous or clear cell histologic type. Indeed, many studies have demonstrated that adjuvant chemotherapy for highrisk endometrial cancer does not improve survival rates [24,25]. However, the results of randomized trials have varied, and some previous studies have suggested that adjuvant chemotherapy after surgery is benefcial for early stage EC with HIR factors [26].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Sun

Zhou

et al. 2023

International Journal of Clinical Practice

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Objective. To evaluate whether postoperative adjuvant treatment is beneficial for patient survival after surgery for early stage endometrial cancer (EC). We analyzed the outcomes of patients treated with radiotherapy, chemotherapy, or progestagen combined with other adjuvant treatments. Methods. We analyzed the outcomes of patients treated with radiotherapy alone, chemotherapy alone, or progestagen treatment with other adjuvant treatments. Women without any adjuvant treatment after operation were used as controls. We retrospectively examined disease-free survival (DFS), overall survival (OS), and high-risk factors that affected the survival status of all patients who received different postoperative adjuvant therapies. Results. In all 192 patients, the total relapse and mortality rates were 5.57% and 1.68%, respectively. Fourteen patients (7.29%) developed isolated local recurrence, and 2 patients died (1.04%) of recurrence during the follow-up period. The 5-year DFS and OS rates of all patients were 95.83% and 93.75%, respectively. No significant differences were observed in the 5-year DFS, 5-year OS, OS, or DFS among the four groups of patients with FIGO stage I endometrial cancer ( P = 0.9849 , 0.7430, 0.9754, and 0.4534, respectively). The differences in the log-rank test results of the estimates of the 5-year DFS, 5-year OS, DFS, and OS of patients with different disease stages and different ages were all significant, but no differences were observed in these parameters among patients with varying degrees of differentiation. Histologic grade, CA125 level, ER and PR status, and adjuvant therapy had no significant effect on the DFS and OS of all patients according to univariate and multivariate regression analyses, but a significant effect on DFS and OS was found when the patients were stratified by age. Conclusion. This retrospective study showed that adjuvant therapy after surgery was not significantly associated with improved DFS or OS in patients with early stage endometrial cancer. However, FIGO stage and age affected the survival of patients with stage I endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Sun

Zhou

et al. 2023

International Journal of Clinical Practice

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“…The data suggested that women gain little bene t from adjuvant chemotherapy, including women with high risk factors, such as deep myometrial invasion and the serous or clear cell histologic type. Indeed, many studies have demonstrated that adjuvant chemotherapy for high-risk endometrial cancer does not improve survival rates [29][30]. However, the results of randomized trials have varied, and some previous studies have suggested that adjuvant chemotherapy after surgery is bene cial for early-stage EC with HIR factors.…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Results of Postoperative Adjuvant Treatment In Women With Stage I Endometrial Cancer

Fu¹,

Zhou²,

Cui³

et al. 2021

Preprint

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Background: It remains controversial whether postoperative adjuvant treatment is beneficial for the survival of patients after surgery for early-stage endometrial cancer. To evaluate whether postoperative adjuvant treatment is beneficial for the survival of patients after surgery for early-stage endometrial cancer. We analyzed the outcomes of patients treated with radiotherapy, chemotherapy, or progestagen combined with other adjuvant treatments. Methods: We retrospectively examined disease-free survival (DFS), overall survival (OS) and high risk factors that affected the survival status of all patients who received different postoperative adjuvant therapies. Results: The total relapse and mortality rates were 5.57% and 1.68%, respectively. During follow-up period, fourteen patients (7.29%) developed isolated local recurrence, and 2 patients died (1.04%) of recurrence. The 5-year DFS and OS rates in all patients were 95.83% and 93.75%, respectively. No significant differences were observed in the 5-year DFS, 5-year OS, OS, or DFS among the four groups of patients with FIGO stage I endometrial cancer. The differences in the log-rank test results of the estimates of the 5-year DFS, 5-year OS, DFS and OS of patients with different disease stages and different ages were all significant, but no differences were observed in these parameters between patients with varying degrees of differentiation. Histologic grade, CA125 level, ER and PR status and whether adjuvant therapies had no significant effect on the DFS and OS of all patients according to univariate and multivariate regression analyses, but age stratification did reveal significant differences in DFS and OS in the univariate and multivariate analyses. Conclusion: This retrospective study showed that adjuvant treatments after surgery were not significantly associated with improved DFS or OS in patients with early-stage endometrial cancer. However, FIGO stage and age affected the survival of patients with stage I endometrial cancer.

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Prognosis and adjuvant chemotherapy for patients with positive peritoneal cytology in stage IA endometrial cancer

Kanno

Yunokawa

Nakabayashi

et al. 2022

Sci Rep

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This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. We retrospectively analyzed the data of patients with stage IA endometrial cancer admitted in our hospital between 2005 and 2015. Among 989 patients who underwent peritoneal cytology, 135 (13.7%) had PPC. Multivariate analysis extracted several independent risk factors for recurrence in stage IA patients, including those with PPC. Adjuvant chemotherapy did not cause a significant difference in the 5-year relapse-free survival rate in patients with PPC (p = 0.78). Similarly, the 5-year recurrence-free survival rate with or without chemotherapy was not different among type II cancer patients (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in patients with PPC and type II was very low (66.7%). While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. While it is controversial whether adjuvant chemotherapy should be administered in stage IA uterine cancer with only PPC as a prognostic factor, it should be considered for early-stage patients who have multiple risk factors for recurrence.

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Chemotherapy as Adjuvant Treatment for Early Stage Endometrial Cancer With High Intermediate Risk Factors

Abstract: Chemotherapy is feasible and safe as adjuvant treatment for early-stage EC with HIR factors. Three cycles of platinum-based chemotherapy are sufficient for reducing the risk of recurrence. Further, large sample randomized studies are needed to confirm these results.

Cited by 3 publications

References 20 publications

Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Ten-Year Results of Postoperative Adjuvant Treatment In Women With Stage I Endometrial Cancer

Prognosis and adjuvant chemotherapy for patients with positive peritoneal cytology in stage IA endometrial cancer

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