Cost-effectiveness of adjuvant radiotherapy in intermediate risk endometrial cancer

Rankins, N. Calloway; Secord, Angeles Alvarez; Jewell, Elizabeth L.; Havrilesky, L.; Soper, John T.; Myers, Evan R.

doi:10.1016/j.ygyno.2007.04.015

Cited by 21 publications

(10 citation statements)

References 17 publications

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“…A risk stratification algorithm, published in GOG99 (8), has been increasingly used to guide adjuvant therapy for patients with intermediate and high-risk endometrial adenocarcinoma (9,10). However, it is unknown whether this risk stratification algorithm is suitable for G3EEC, and it is unclear if there is an association between conventional prognostic indicators and prognosis among G3EEC patients.…”

Section: Introductionmentioning

confidence: 99%

Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

Wang

Nan

et al. 2016

Oncology Letters

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Abstract. The aim of the present study was to determine risk factors associated with recurrence and survival in patients with grade 3 endometrioid endometrial carcinoma (G3EEC). A retrospective analysis of 117 patients with G3EEC, who were admitted to the Obstetrics and Gynecology Hospital of Fudan University between January 2000 and December 2011, was performed. The χ 2 test or Fisher's exact test were used for the comparison of categorical variables. Kaplan-Meier method was used for estimating recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) rates. Univariate and multivariate Cox proportional hazards model were used to assess the prognostic significance of various patient characteristics. In 117 patients, 16 patients (13.7%) had tumor recurrence, of which 6 (37.5%) developed local-regional recurrence and 10 (62.5%) developed distant recurrence. Out of the 16 patients with tumor recurrence, 14 (87.5%) had a recurrence within 3 years of surgery. Statistically significant characteristics affecting RFS, DSS and OS rates were outer half myometrial invasion (MI ≥50%), advanced International Federation of Gynecology and Obstetrics stage, positive lymph node metastasis (PLNM), lymph vascular space invasion, adnexal involvement and characterization as a high-risk group, according to the Gynecologic Oncology Group 99 stratification algorithm. RFS was associated with the depth of cervical mucosa (stromal) involvement. Furthermore, in the multivariate Cox proportional hazards model, significant independent adverse factors for RFS and DSS included MI ≥50% and adnexal involvement. For OS, there were no statistically significant prognostic factors. In conclusion, MI ≥50% and adnexal involvement are independent prognostic factors for RFS and DSS in G3EEC patients.

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Section: Introductionmentioning

confidence: 99%

Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

Wang

Nan

et al. 2016

Oncology Letters

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“…It would be important to be able to counsel patients on the expected QOL effects of these treatment modalities, which will then further form the basis for the design of individualized treatment plans and future supportive care service delivery. In addition, quantitative QOL data are urgently needed to plan for cost-effective treatment algorithms (15). We prospectively performed longitudinal evaluations of QOL in endometrial cancer patients to study the effect of surgery and adjuvant RT.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Assessments of Quality of Life in Endometrial Cancer Patients: Effect of Surgical Approach and Adjuvant Radiotherapy

Menard

Samant

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

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“…11 However, an intermediate risk category has been defined as lesions that invade the myometrium (stage IB/IC) or cervix (stage IIA/IIB) are characterized by pathological features that considerably increase the risk of both loco-regional and distant relapse. 2 While treatment modality for low risk, high intermediate risk and high risk endometrial cancers have gained clarity, adjuvant whole pelvic radiotherapy for patients with intermediate-risk endometrial cancer (IA G3, IB G2) is still being endorsed. 2,12 Recent data from two prospective randomized clinical trials show a reduction in recurrence rates by adjuvant whole pelvic radiotherapy following total abdominal hysterectomy and bilateral salpingooophorectomy (TAH-BSO) with or without lymph node sampling.…”

Section: Discussionmentioning

confidence: 99%

“…2 While treatment modality for low risk, high intermediate risk and high risk endometrial cancers have gained clarity, adjuvant whole pelvic radiotherapy for patients with intermediate-risk endometrial cancer (IA G3, IB G2) is still being endorsed. 2,12 Recent data from two prospective randomized clinical trials show a reduction in recurrence rates by adjuvant whole pelvic radiotherapy following total abdominal hysterectomy and bilateral salpingooophorectomy (TAH-BSO) with or without lymph node sampling. However, neither of these trials demonstrated that adjuvant pelvic radiotherapy improved overall survival.…”

Section: Discussionmentioning

confidence: 99%

“…This intermediate risk category has been defined as lesions that invade the myometrium (stage IB/IC) or cervix (stage IIA/IIB). 2 The standard treatment for patients with stage I endometrial cancer is surgery, consisting of peritoneal lavage for cytology, extra-fascial total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO) and dissection of pelvic and aortic nodes. 3 Intraoperative inspection and palpation of abdominal organs, including the diaphragm, liver, omentum, and pelvic and bowel peritoneal surfaces together with the pathological results form the optimal basis of future adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

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Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer

Koçak¹,

Eren²,

Naki³

et al. 2011

UHOD

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Present study was designed to evaluate potential risks and benefits of adjuvant radiotherapy in selected patients with intermediate-risk endometrial cancer. A total of 100 patients with stage IB grade II endometrial cancer followed up in Radiation Oncology Clinic at Dr. Lutfi Kirdar Training and Research Hospital were evaluated retrospectively to determine the influence of postsurgical adjuvant radiotherapy on disease-free survival, local recurrences and locally-relaps free survival. Side effects related to adjuvant radiotherapy were also evaluated. Forty-seven (47%) patients were determined to undergo total abdominal hysterectomy + bilateral salphingo-oopherectomy and 53 (53%) patients, total abdominal hysterectomy + bilateral salphingo-oopherectomy + pelvic lymph node dissection. Postsurgical adjuvant radiotherapy was administered in 77 patients (77%), while the surgery was the sole medical intervention for 23 patients (23%). The median follow-up period was 40.5 months (range: 6-139) Five-year disease-free survival (96.6% vs. 80.5%; p< 0.01) and local control (98.6% vs. 80.5%; p<0.05) were better in patients who were administered postoperative radiotherapy compared to patients without postoperative radiotherapy. In conclusion, while our results concerning homogenous sub-population of patients with stage IB grade II endometrial cancer seem to support the use of postoperative adjuvant radiotherapy, larger and more detailed prospective studies are required for determination of its exact prognostic value. Keywords: endometrial cancer stage IB, Adjuvant radiotherapy, Overall survival ÖZET Post-operatif Adjuvan Radyoterapinin Stage IB Grade 2 Endometrium Kanseri Hasta Popülasyonunda Uzun Dönem Faydalar›Bu çal›flma orta risk endometrium kanserli hasta populasyonunda adjuvant radyoterapinin potansiyel risk ve yararlar›n› de¤erlendirmek amac›yla tasarland›. Stage IB grade II endometrium kanseri tan›s›yla Dr. Lutfi K›rdar E¤itim ve Araflt›rma Hastanesi Radyasyon Onkolojisi Klini¤in-de izlenmekte olan toplam 100 hastada postoperatif adjuvant radyoterapinin hastal›ks›z sa¤ kal›m, lokal rekürrens ve lokal kontrol oranlar›na etkisi retrospektif olarak belirlendi. Adjuvan radyoterapiye yönelik yan etkiler de ayr›ca de¤erlendirildi.

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Cost-effectiveness of adjuvant radiotherapy in intermediate risk endometrial cancer

Cited by 21 publications

References 17 publications

Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

Longitudinal Assessments of Quality of Life in Endometrial Cancer Patients: Effect of Surgical Approach and Adjuvant Radiotherapy

Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer

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