Long-Term Survival of Intermediate Risk Endometrial Cancer (Stage IG3, IC, II) Treated with Full Lymphadenectomy and Brachytherapy without Teletherapy

Fanning, James

doi:10.1006/gyno.2001.6276

Cited by 103 publications

(45 citation statements)

References 10 publications

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“…It seems that the survival difference is due to whether the lymphadenectomy is performed. Some investigators proposed that complete lymphadenectomy with tailored adjuvant therapy for intermediate-risk endometrial cancer results in excellent survival [2,25]. Fanning [2] investigated 66 intermediate-risk patients who underwent surgery consisting of TAH-BSO with complete pelvic and para-aortic lymphadenectomy followed by postoperative VBT.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were staged according to the revised 2009 International Federation of Gynecology and Obstetrics (FIGO) surgical staging system [19]. Categorization of risk grouping was based on the FIGO stage, tumor histology, and tumor grade and adjuvant treatment was given to patients with risk factors for recurrence with data from the GOG as reference [1,2]. Patients with disease of FIGO stage IA with grade 1–2 endometrioid adenocarcinoma were classified as low risk, those with any grade 3 tumor limited to the uterine corpus (stage IA and IB) grade 1–2 tumor with >50% myometrial invasion (stage IB), and occult stage II were classified as intermediate risk, and those with extrauterine spread to adnexa, vaginal, lymph nodes, or other organs were classified as high risk.…”

Section: Methodsmentioning

confidence: 99%

“…The recurrence rate for low-risk tumors is approximately 5%, for intermediate-risk tumors 10%, and for high-risk tumors 14–42% [2]. Adjuvant treatment should be planned and given in this context.…”

Section: Introductionmentioning

confidence: 99%

“…Surgically staged endometrial cancer patients can be classified into three categories on the basis of pathological risk factors [1,2,3]. The recurrence rate for low-risk tumors is approximately 5%, for intermediate-risk tumors 10%, and for high-risk tumors 14–42% [2].…”

Section: Introductionmentioning

confidence: 99%

“…Prospective randomized trials showed that EBRT decreased the risk of locoregional recurrence but did not improve overall survival (OS) rates in intermediate-risk patients [4,5,6]. Vaginal brachytherapy (VBT) is increasingly used for low- or intermediate-risk patients with improved local control of disease and low toxicity [2,7,8,9,10,11,12,13,14,15]. Recently, the results of the Post-Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-2 trial were published, this study suggested that VBT was more effective in reducing vaginal recurrence and had fewer gastrointestinal toxicities than EBRT [16].…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive Staging Surgery Including Complete Pelvic and Para-Aortic Lymphadenectomy Followed by Adjuvant Vaginal Brachytherapy Improves Survival Rates for Intermediate-Risk Endometrial Cancer Patients

Kong¹,

Paek²,

Chang³

et al. 2012

Gynecol Obstet Invest

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Aim: To investigate the survival of patients with intermediate-risk endometrial cancer treated with comprehensive staging surgery including complete pelvic and para-aortic lymphadenectomy and adjuvant vaginal brachytherapy (VBT). Methods: Between January 2000 and December 2009, we retrospectively reviewed the medical records of 156 patients who underwent comprehensive surgical staging consisting of total hysterectomy, adnexectomy, peritoneal cytology, and complete pelvic/para-aortic lymphadenectomy. There were 122 low-risk and 34 intermediate-risk patients, and intermediate-risk patients received adjuvant VBT. Results: During the follow-up period, 7 (4.5%) of the 156 patients developed recurrent disease: 3 (2.5%) of the 122 low-risk and 4 (11.8%) of the 34 intermediate-risk patients. Among the 7 patients with recurrent disease, only 1 intermediate-risk patient died of disease and 6 stayed alive for the rest of the follow-up period. Disease-free survival at 5 years was 95.7% in the low-risk patients and 81.6% in the intermediate-risk patients, and this difference was statistically significant (p = 0.009). There was no statistically significant difference in overall survival at 5 years between the two groups (100% in low-risk patients vs. 96.7% in intermediate-risk patients, p = 0.061). Overall, grade 3 toxicities were seen in 1 (2.9%) patient. Conclusion: Comprehensive staging surgery including complete pelvic and para-aortic lymphadenectomy followed by adjuvant VBT improves survival rates for intermediate-risk endometrial cancer patients, which are comparable with those of low-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comprehensive Staging Surgery Including Complete Pelvic and Para-Aortic Lymphadenectomy Followed by Adjuvant Vaginal Brachytherapy Improves Survival Rates for Intermediate-Risk Endometrial Cancer Patients

Kong¹,

Paek²,

Chang³

et al. 2012

Gynecol Obstet Invest

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Therapeutic role of lymph node resection in endometrioid corpus cancer

Chan

Cheung

Huh

et al. 2006

Cancer

375

209

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Single cell transcriptomes of normal endometrial derived organoids uncover novel cell type markers and cryptic differentiation of primary tumours

Cochrane

Campbell

Greening

et al. 2020

The Journal of Pathology

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Endometrial carcinoma, the most common gynaecological cancer, develops from endometrial epithelium which is composed of secretory and ciliated cells. Pathologic classification is unreliable and there is a need for prognostic tools. We used single cell sequencing to study organoid model systems derived from normal endometrial endometrium to discover novel markers specific for endometrial ciliated or secretory cells. A marker of secretory cells (MPST) and several markers of ciliated cells (FAM92B, WDR16, and DYDC2) were validated by immunohistochemistry on organoids and tissue sections. We performed single cell sequencing on endometrial and ovarian tumours and found both secretory‐like and ciliated‐like tumour cells. We found that ciliated cell markers (DYDC2, CTH, FOXJ1, and p73) and the secretory cell marker MPST were expressed in endometrial tumours and positively correlated with disease‐specific and overall survival of endometrial cancer patients. These findings suggest that expression of differentiation markers in tumours correlates with less aggressive disease, as would be expected for tumours that retain differentiation capacity, albeit cryptic in the case of ciliated cells. These markers could be used to improve the risk stratification of endometrial cancer patients, thereby improving their management. We further assessed whether consideration of MPST expression could refine the ProMiSE molecular classification system for endometrial tumours. We found that higher expression levels of MPST could be used to refine stratification of three of the four ProMiSE molecular subgroups, and that any level of MPST expression was able to significantly refine risk stratification of the copy number high subgroup which has the worst prognosis. Taken together, this shows that single cell sequencing of putative cells of origin has the potential to uncover novel biomarkers that could be used to guide management of cancers. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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Long-Term Survival of Intermediate Risk Endometrial Cancer (Stage IG3, IC, II) Treated with Full Lymphadenectomy and Brachytherapy without Teletherapy

Cited by 103 publications

References 10 publications

Comprehensive Staging Surgery Including Complete Pelvic and Para-Aortic Lymphadenectomy Followed by Adjuvant Vaginal Brachytherapy Improves Survival Rates for Intermediate-Risk Endometrial Cancer Patients

Comprehensive Staging Surgery Including Complete Pelvic and Para-Aortic Lymphadenectomy Followed by Adjuvant Vaginal Brachytherapy Improves Survival Rates for Intermediate-Risk Endometrial Cancer Patients

Therapeutic role of lymph node resection in endometrioid corpus cancer

Single cell transcriptomes of normal endometrial derived organoids uncover novel cell type markers and cryptic differentiation of primary tumours

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