Endometrial carcinoma: Treatment of positive paraaortic nodes

Feuer, Gerold; Calanog, Anthony

doi:10.1016/0090-8258(87)90236-8

Cited by 39 publications

(12 citation statements)

References 4 publications

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“…In the present study, 5-year survival of patients with aortic node metastases (group A) (75%) was much better than previously reported (0-60%) (Komaki et al, 1983;Potish et al, 1985;Blythe et al, 1986;Feuer et al, 1987;Larson et al, 1987;Coin et al, 1992;Rose et al, 1992;Hicks et al, 1993;Kadar et al, 1994). In particular, aortic node-positive patients with pTl/2 or endometrioid GI cancer had a good prognosis (91% 5-year survival).…”

Section: Incidence and Distribution Of Lymph Node Metastasescontrasting

confidence: 55%

“…However, aortic and pelvic lymphadenectomy is not regarded as the standard surgical procedure for endometrial cancer, even among patients at high risk for lymph node metastases, because the therapeutic significance of the procedure has not yet been sufficiently demonstrated (Calais et al, 1990;Belinson et al, 1992;Kim et al, 1993;Faught et al, 1994;Chuang et al, 1995;Kilgore et al, 1995). Feuer et al (1987) and Rose et al (1992) reported that postsurgical radiotherapy was effective for microscopic node metastases of endometrial cancer, whereas it had no favourable effect on macroscopic node metastases. On the other hand, the response Received 22 October 1996Revised 24 December 1996 Accepted 18 January 1997 Correspondence to: T Onda, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113, Japan rate of chemotherapy for endometrial cancer has been reported to be 30-57% (Seski et al, 1982;Hancock et al, 1986;Green et al, 1990), which is still lower than that for ovarian cancer.…”

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confidence: 99%

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Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy

Onda

Yoshikawa²,

Mizutani³

et al. 1997

Br J Cancer

162

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SummaryWe assessed the therapeutic significance of systematic aortic and pelvic lymphadenectomy followed by adjuvant therapy in nodepositive endometrial carcinoma. Among 173 stage lll patients, 30 (17%) had positive nodes: ten in the pelvic region alone (group P) and 20 in the aortic region alone or in both regions (group A). The adjuvant therapy was administered as follows: subjects in group P received 50 Gy pelvic radiation, including three post-surgical T3 (pT3) patients who received either one or three cycles of cisplatin-based chemotherapy before radiation. Subjects in group A were given three cycles of chemotherapy followed by 50 Gy pelvic and 50 Gy extended field periaortic radiation using a four-field or conformational technique. Five-year survival was 95% for 143 patients with negative nodes and 84% for 30 patients with positive nodes (100% for group P and 75% for group A). In group A, 5-year survival was 38% for eight patients with both pT3 and histology other than endometrioid type Gl, and 91% for the remaining 12 patients. Either way, both group P and group A patients had a better prognosis than previously reported. In summary, aortic and pelvic lymphadenectomy and subsequent chemotherapy and radiation therapy based on node status seem to improve the survival of endometrial cancer patients with positive nodes.

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Section: Incidence and Distribution Of Lymph Node Metastasescontrasting

confidence: 55%

mentioning

confidence: 99%

Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy

Onda

Yoshikawa²,

Mizutani³

et al. 1997

Br J Cancer

162

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“…(FIGO) and the American Joint Committee on Cancer (AJCC) stage IIIC disease represents a minority of all new endometrial carcinoma cases, these patients will account for a significant proportion of tumor-related deaths, as evidenced by the relatively poor long-term survival rates (27% to 58%) achievable with conventional postoperative radiation therapy (8,(10)(11)(12)(13)(14)(15)(16) . This observation underscores the need to more precisely define important prognostic factors and to develop effective management strategies for patients with node-positive disease.…”

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confidence: 99%

FIGO stage IIIC endometrial carcinoma: Resection of macroscopic nodal disease and other determinants of survival

Bristow

Zahurak

Alexander

et al. 2003

Int J Gynecol Cancer

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The objective of this study was to evaluate the potential survival benefit of debulking macroscopic adenopathy and other clinical prognostic factors among patients with node-positive endometrial carcinoma. Demographic, operative, pathologic, & follow-up data were abstracted retrospectively for 41 eligible patients with FIGO stage IIIC endometrial cancer. Survival curves were generated using the Kaplan-Meier method and statistical comparisons were performed using the log rank test, logistic regression analysis, and the Cox proportional hazards regression model. All patients had positive pelvic lymph nodes and 20 patients (48.8%) had positive para-aortic lymph nodes. Postoperatively, all patients received whole pelvic radiation therapy, 17 received extended-field radiation therapy, and 15 patients received chemotherapy. The median disease-specific survival (DSS) time for all patients was 30.6 months (median follow-up 34. 0 months). Patients with completely resected macroscopic lymphadenopathy had a significantly longer median DSS time (37.5 months), compared to patients left with gross residual nodal disease (8.8 months, P = 0.006). On multivariate analysis, independent predictors of DSS were gross residual nodal disease (HR 7.96, 95% CI 2.54–24.97, P < 0. 001), age ≥ 65 years (HR 6.22, 95% CI 2.05–18.87, P = 0.001), and the administration of adjuvant chemotherapy (HR 0.22, 95% CI 0.07–0.76, P = 0.016). We conclude that in patients with stage IIIC endometrial carcinoma, complete resection of macroscopic nodal disease and the administration of adjuvant chemotherapy, in addition to directed radiation therapy, are associated with improved survival.

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“…When recurrence did occur it was often outside the pelvis. It would seem more sensible to reserve radiotherapy, whether local or external, before or after the operation, for the more invasive or more advanced tumours (Belinson et al, 1985;Di Saia et al, 1985;Stokes et al, 1985: Shimm et nl., 1986Feuer and Calanog, 1987). Analysis of the patients dying within the first two years of starting treatment indicates that these patients are often poor risks.…”

Section: Discussionmentioning

confidence: 98%

Carcinoma of the endometrium; 300 patients managed in a District General Hospital

Mukoyogo

Smith

1988

Journal of Obstetrics and Gynaecology

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Endometrial carcinoma: Treatment of positive paraaortic nodes

Cited by 39 publications

References 4 publications

Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy

Treatment of node-positive endometrial cancer with complete node dissection, chemotherapy and radiation therapy

FIGO stage IIIC endometrial carcinoma: Resection of macroscopic nodal disease and other determinants of survival

Carcinoma of the endometrium; 300 patients managed in a District General Hospital

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