Postoperative Adjuvant Treatment in Women with Stage I Endometrial Cancer: A Retrospective Study

Abstract

Objective. To evaluate whether postoperative adjuvant treatment is beneficial for patient survival after surgery for early stage endometrial cancer (EC). We analyzed the outcomes of patients treated with radiotherapy, chemotherapy, or progestagen combined with other adjuvant treatments. Methods. We analyzed the outcomes of patients treated with radiotherapy alone, chemotherapy alone, or progestagen treatment with other adjuvant treatments. Women without any adjuvant treatment after operation were used as controls. We retrospectively examined disease-free survival (DFS), overall survival (OS), and high-risk factors that affected the survival status of all patients who received different postoperative adjuvant therapies. Results. In all 192 patients, the total relapse and mortality rates were 5.57% and 1.68%, respectively. Fourteen patients (7.29%) developed isolated local recurrence, and 2 patients died (1.04%) of recurrence during the follow-up period. The 5-year DFS and OS rates of all patients were 95.83% and 93.75%, respectively. No significant differences were observed in the 5-year DFS, 5-year OS, OS, or DFS among the four groups of patients with FIGO stage I endometrial cancer ( P = 0.9849 , 0.7430, 0.9754, and 0.4534, respectively). The differences in the log-rank test results of the estimates of the 5-year DFS, 5-year OS, DFS, and OS of patients with different disease stages and different ages were all significant, but no differences were observed in these parameters among patients with varying degrees of differentiation. Histologic grade, CA125 level, ER and PR status, and adjuvant therapy had no significant effect on the DFS and OS of all patients according to univariate and multivariate regression analyses, but a significant effect on DFS and OS was found when the patients were stratified by age. Conclusion. This retrospective study showed that adjuvant therapy after surgery was not significantly associated with improved DFS or OS in patients with early stage endometrial cancer. However, FIGO stage and age affected the survival of patients with stage I endometrial cancer.

The role of preoperative serum CA-125 levels in predicting lymph node metastasis in patients undergoing treatment for endometrial cancer

“…Lymph node involvement was present in 17.48% of women with endometrial cancer. The median (IQR) number of lymph nodes collected during surgery was 16 (12)(13)(14)(15)(16)(17)(18)(19)(20) for pelvic and 4 (3-5) for paraaortic nodes. The mean CA-125 level for patients was 28.8±33.0.…”

“…15 On the other hand, in a study encompassing risk factors affecting overall survival and disease-free survival in early-stage endometrial cancer, it was found that CA-125 had no significant effect on overall survival and disease-free survival. 16 The accurate staging of endometrial cancer relies on well-established and evidence-based surgical staging protocols. Clinical staging alone lacks precision and cannot evaluate critical factors such as LVSI, grade, or A cutoff value of >35 was determined for the advanced stage with 96% sensitivity and 92.4% specificity according to the ROC Curve analysis in our study.…”