Compliance to surgical and radiation treatment guidelines in relation to patient outcome in early stage endometrial cancer

Lankveld, M. A. L. van; Koot, Nicole C M; Peeters, Petra H.M.; Leeuwen, Jules Schagen van; Jürgenliemk-Schulz, Ina M.; Eijkeren, M. A. Van

doi:10.1111/j.1365-2753.2006.00618.x

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…20,22 In endometrial cancer, prior studies mainly examined guideline adherence to surgical treatment recommendation or mixed with other malignancies, and no study has solely examined the association of patient noncompliance for postoperative radiotherapy and survival. [23][24][25][26][27][28][29] Our results of decreased survival in non-compliant women with endometrial cancer for postoperative radiotherapy are consistent with past studies reporting decreased survival related to non-compliance to radiotherapy shown in other malignancies. 6,7,29 Therefore, our study not only validates their results but also endorses that patient compliance for radiotherapy is an important factor for prognosis of women with endometrial cancer.…”

Section: Discussionsupporting

confidence: 91%

“…Both the care provider‐side and the patient‐side can be factored for the guideline adherence, and these possible guideline adherent factors include hospital volume, patient medical comorbidities, and patient non‐compliance . In endometrial cancer, prior studies mainly examined guideline adherence to surgical treatment recommendation or mixed with other malignancies, and no study has solely examined the association of patient non‐compliance for postoperative radiotherapy and survival …”

Section: Discussionmentioning

confidence: 99%

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Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer

Matsuo

Machida

Ragab

et al. 2017

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer

Matsuo

Machida

Ragab

et al. 2017

Journal of Surgical Oncology

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“…LND in intermediate/high-risk EC has been also studied in numerous retrospective trials, showing controversial results in relation to its survival beneﬁt [ 22 23 ]. Our group recently performed a retrospective matched pair study, which included 194 (97 pairs) diagnosed of high-risk EC, finding no benefit in DFS and OS of LND [ 10 ].…”

Section: Disccussionmentioning

confidence: 99%

Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study

et al. 2018

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ObjectiveTo assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC).MethodsA multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1–2; or cervical involvement and grades 1–2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups.ResultsBoth study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0–275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79–2.28) and OS (HR=0.72; 95% CI=0.42–1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups.ConclusionSystematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.

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“…LND in intermediate/high-risk EC has been also studied in numerous retrospective trials, showing controversial results in relation to its survival benefit [22,23]. Our group recently performed a retrospective matched pair study, which included 194 (97 pairs) diagnosed of high-risk EC, finding no benefit in DFS and OS of LND [10].…”

Section: Disccussionmentioning

confidence: 99%

Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study

et al. 2018

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Objective: To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC). Methods: A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1-2; or cervical involvement and grades 1-2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups. Results: Both study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0-275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79-2.28) and OS (HR=0.72; 95% CI=0.42-1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups. Conclusion: Systematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.

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Compliance to surgical and radiation treatment guidelines in relation to patient outcome in early stage endometrial cancer

Abstract: This suggests that extensive surgical procedures are redundant in the treatment of occult stage II endometrial cancer.

Cited by 15 publications

References 7 publications

Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer

Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer

Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study

Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study

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