Impact of different adjuvant treatment approaches on survival in stage III endometrial cancer: A population-based study

Abstract

Background: Patients with International Federation of Gynaecology and Obstetrics (FIGO) stage III endometrial cancer (EC) have a substantial risk of adverse outcomes. After surgery, adjuvant therapy is recommended with external beam radiotherapy (EBRT), chemotherapy (CT) or both EBRT and CT. Recent trials suggest that EBRT þ CT is superior to EBRT or CT alone but also results in more toxicity. We have compared the outcome of different adjuvant treatments in a population-based cohort to identify subgroups that benefit most from EBRT þ CT. Methods: All patients diagnosed with FIGO stage III EC and treated with surgery in 2005 e2016 were identified from the Netherlands Cancer Registry. The primary outcome was overall survival (OS); associations with adjuvant treatment were analysed using Cox regression analysis. Results: Among 1241 eligible patients, EBRT þ CT was associated with a better OS than CT (hazard ratio [HR] Z 1.84, 95% confidence interval [CI] Z 1.34e2.52) and EBRT alone (HR Z 1.37, 95% CI Z 1.05e1.79). In stage IIIC, there was a significant benefit of

Immunohistochemical biomarkers are prognostic relevant in addition to the ESMO-ESGO-ESTRO risk classification in endometrial cancer

“…The study of Ouldamer et al concluded, that even patients within the 'high-intermediate' risk group should receive systematic nodal staging for a significant better survival [34]. This is in line with recent paper of Weelden et al that demonstrated that patients with FIGO IIIA-B had significant improved outcome if LN were sampled and negative [35]. Our results show the prognostic relevance of IHC expression in addition to LN status, similar to other studies [17,19].…”

What Has Changed in the Management of Uterine Serous Carcinomas? Two Decades of Experience

“…Similar results were obtained from the retrospective study of Nasioudis et al for early-stage USC [ 41 ]. Additionally, our findings accentuate the diversity of treatments and their combination used in the adjuvant setting in this patients’ cohort, which are consistent with previous studies in other countries [ 42 , 43 ] and reflect the corresponding treatment options suggested by international guidelines [ 35 ]. Molecular classification of the disease and guidelines that have incorporated clinical and molecular evidence of the disease will lay the foundation for personalized treatment in the near future.…”

Risk Stratification of Endometrial Cancer Patients: FIGO Stage, Biomarkers and Molecular Classification

“…Weelden et al provided specific data for FIGO IIIA–B and C patients within a large population-based study [ 48 ]. Subgroup analysis did not observe a benefit of combined treatment modalities in FIGO IIIA–B.…”