Pelvic radiation in stage I endometrial adenocarcinoma with high-risk attributes

Marchetti, David L.; Caglar, H; Driscoll, Deborah L.; Hreshchyshyn, Myroslaw M.

doi:10.1016/0090-8258(90)90307-7

Cited by 20 publications

(3 citation statements)

References 9 publications

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“…Staging is important because stage IC carcinomas carry an increased risk of lymph node metastasis (2)(3)(4)(5)(6), lymphovascular invasion (7), and local recurrence (8), which may be independent of the degree of tumor differentiation (9). Lymphadenectomy and/or postoperative radiotherapy, therefore, may be considered in this group of patients to reduce the risk of node metastasis (5) and local recurrence (8,10). However, assessment of the depth of tumor invasion into the myometrium, and hence accurate pathologic staging, can be difficult in practice.…”

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confidence: 99%

Assessment of Uterine Wall Thickness and Position of the Vascular Plexus in the Deep Myometrium: Implications for the Measurement of Depth of Myometrial Invasion of Endometrial Carcinomas

Williams

Hirschowitz

2006

International Journal of Gynecological Pathology

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Accurate discrimination between FIGO stages IB and IC endometrial carcinomas has important prognostic and therapeutic implications, but depth of invasion as a percentage of myometrial thickness can be difficult to ascertain. In such cases, pathologists often presume that infiltration that reaches the arcuate vascular plexus (AVP) in the myometrium indicates >50% myoinvasion. The further assumption is sometimes made that the anterior and posterior uterine walls are of the same thickness. To our knowledge, neither supposition is based on published data. We performed a prospective study of myometrial thickness and the position of the AVP in 50 normal uteruses from patients aged 27 to 84 years. Myometrial thickness varied inversely with age (p < 0.0001); however, anterior and posterior wall myometrial thickness did not differ significantly in the cohort as a whole (p = 0.059) and in individual cases was highly correlated (p < 0.0001). The position of the AVP was variable. On average, its inner limit was situated at a depth of 47.3% of the thickness of the myometrium in both uterine walls, but the position varied between individuals and sometimes differed considerably between the anterior and posterior walls of the same uterus. The position of the AVP did not differ significantly with age. We conclude that carcinomatous infiltration well into or through the AVP usually signifies >50% myoinvasion; however, if infiltration barely extends into the AVP, the depth of invasion should be calculated with reference to the thickness of the myometrium in the opposite uterine wall.

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confidence: 99%

Assessment of Uterine Wall Thickness and Position of the Vascular Plexus in the Deep Myometrium: Implications for the Measurement of Depth of Myometrial Invasion of Endometrial Carcinomas

Williams

Hirschowitz

2006

International Journal of Gynecological Pathology

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“…External radiotherapy has clearly shown its importance in reducing loco-regional recurrence [9,12,15,19,20,21,22].…”

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confidence: 99%

Impact of External Radiotherapy on Survival after Stage I ndometrial Cancer: Results from a Population-Based Study

Tebeu¹,

Verkooijen²,

Popowski³

et al. 2011

JCST

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Purpose: To assess the impact of external radiotherapy on the survival of patients with early stage endometrial cancer in a population-based setting. Patients and methods:Using information from the Geneva Cancer Registry, we identified all patients who underwent operations for endometrial cancer between 1980 and 1996. We excluded patients with tumours that had spread beyond the uterus, patients without myometrial invasion and patients with poorly differentiated, deeply invasive tumours. Adjusting for other prognostic variables, a Cox proportional hazards analysis was used to calculate the diseasespecific risks and the overall mortality risks in patients treated with brachytherapy or external radiotherapy compared with non-irradiated patients. Stratified analyses were performed for patients with 'low-risk' (superficial myometrial invasion, grades 1-2) and 'high-risk' (superficial invasion grade 3 or deep invasion grades 1-2) tumours. Results:For the 162 patients with low-risk tumours, external radiotherapy was significantly associated with an increased overall mortality (hazard ratio [HR]: 6.4, 95% CI: 1.3-30.2) and endometrial cancer mortality (HR: 9.4, 95% CI: 1.0-86.7). In the group of patients with high-risk tumours (n=108), neither brachytherapy nor external radiotherapy modified the endometrial cancer mortality risk. Conclusion:External radiotherapy does not reduce mortality from early stage endometrial cancer and is associated with a significantly increased overall and endometrial cancer mortality risk among patients with superficially invasive grade 1-2 tumours. .

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“…Die Daten zu diesen Patientinnen sind sehr limitiert. Beispielsweise wurden in einer GOG-Studie [16] [1,4,14,16,17]. Studien mit einem Vergleich alleiniger vaginaler Radiatio vs. vaginaler und perkutaner Radiatio und mit hohem LOE fehlen jedoch oder zeigen keinen Vorteil bei einer kombinierten Radiatio [10].…”

Section: Stadium I Aunclassified

Therapieentscheidungen beim Endometriumkarzinom nach Levels of Evidence und Grades for Recommendation

Brumm

Fasching²,

Mw³

2002

Zentralbl Gynakol

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The evaluation of decisions in treating endometrial cancer according to levels of evidence and grades for recommendation is gaining importance. This can help to evaluate results of studies and publications for guidelines and standards in treating endometrial cancer. - Concerning endometrial cancer there are some publications with a high level of evidence especially in early stages whereas data of treating progressive and advanced disease with a high level of evidence is lacking. - There are some studies with an acceptable level of evidence evaluating radiation and surgical treatment in stages I and II. In stages III and IV further data concerning evaluation of hormonal treatment and chemotherapy is pending.

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Pelvic radiation in stage I endometrial adenocarcinoma with high-risk attributes

Cited by 20 publications

References 9 publications

Assessment of Uterine Wall Thickness and Position of the Vascular Plexus in the Deep Myometrium: Implications for the Measurement of Depth of Myometrial Invasion of Endometrial Carcinomas

Assessment of Uterine Wall Thickness and Position of the Vascular Plexus in the Deep Myometrium: Implications for the Measurement of Depth of Myometrial Invasion of Endometrial Carcinomas

Impact of External Radiotherapy on Survival after Stage I ndometrial Cancer: Results from a Population-Based Study

Therapieentscheidungen beim Endometriumkarzinom nach Levels of Evidence und Grades for Recommendation

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