The role of adjuvant therapy in stage IA serous and clear cell uterine cancer: A multi-institutional pooled analysis

Qu, Xuanlu; Velker, Vikram; Leung, Eric; Kwon, Janice S.; Elshaikh, Mohamed A.; Kong, Iwa; Logie, Natalie; Mendez, Lucas C.; Putten, Louis J. van der; Donovan, Elysia; Munkarah, Adnan; Wiebe, Ericka; Parra‐Herran, Carlos; Warner, Andrew; Louie, Alexander V.; D’Souza, David

doi:10.1016/j.ygyno.2018.03.002

Cited by 34 publications

(20 citation statements)

References 31 publications

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“…Recently, pooled analysis showed that application of adjuvant CT and RT in stage IA endometrial cancer with serous, clear cell or mixed histology was associated with better PFS compared to those from the observation group. Observation might benefit the patients only when there was adequate surgical staging (3). For patients with stage IB and II disease, different adjuvant therapies were recommended in the NCCN guidelines.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

Yin

Cheng

Zhang

et al. 2020

Preprint

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Background : Uterine clear cell carcinoma (UCCC) is a rare histological type of endometrial cancer with poor prognosis and high risk of tumor relapse. Although adjuvant chemotherapy (CT) and/or radiotherapy (RT) are often recommended for early stage UCCC patients, the effectiveness of these treatment strategies remains unclear. Methods : Systematic review and meta-analysis were applied to evaluate treatment-related outcomes of stage I-II UCCC patients. Search strategy was applied using electronic databases until June 1st, 2019. Inclusion criteria were retrospective, observational and prospective studies that reported outcome of UCCC patients receiving adjuvant therapy. Clinical endpoints like overall survival (OS) and progression-free survival (PFS) were evaluated. Data were extracted by two independent reviewers and a meta-analysis was performed. Results : 13 articles with a total of 3967 patients were analyzed. Overall, adjuvant CT after surgery could improve 5 year-OS significantly compared to patients without CT (odds ratio 0.75, 95% confidence interval [CI] 0.58-0.96; p=0.02). In comparison, RT could also improve OS in UCCC patients of early stage (odds ratio 0.58, 95% CI 0.44-0.77; p=0.0002) compared to the patients without RT, especially in US and Europe patients. Lastly, when comparing the patients undergoing both CT and RT with those receiving CT or RT alone, no further improvement in OS was observed (odds ratio 1.12, 95% CI 0.63-1.99; P=0.70). Conclusions : Either CT or RT after surgery could improve the OS of early stage of UCCC patients. However, combinatorial CT and RT treatment did not improve the OS compared with CT or RT treatment alone.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

Yin

Cheng

Zhang

et al. 2020

Preprint

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“…In this study, patients received adjuvant treatment about 66% of all patients. When compared with previous studied, we found only half or less patients received adjuvant treatment (Eggink et al, 2017;Qu et al, 2018).…”

Section: Discussioncontrasting

confidence: 58%

“…Moreover, Erkilinç et al, (2018) reported that the presence of adenomyosis was associated with higher overall survival (HR = 0.20; 95% CI, 0.03-0.68). A possible explanation for these results is that most participants in our study received adjuvant treatment, which can reduce tumor recurrence (Eggink et al, 2017;Iwase et al, 2018;Qu et al, 2018). In this study, patients received adjuvant treatment about 66% of all patients.…”

Section: Discussionmentioning

confidence: 83%

Impact of Coexisting Uterine Adenomyosis on the Survival Outcome of Patients with Endometrial Cancer: A Retrospective Cohort Study

Boonlak

Aue-aungkul

Kietpeerakool

et al. 2019

Asian Pac J Cancer Prev

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Objective:To determine the effects of uterine adenomyosis on endometrial cancerrecurrence rates. Methods: This retrospective cohort study reviewed all consecutive patients diagnosed with endometrial cancerwho underwent total hysterectomy-based surgical staging at Srinagarind Hospital between January, 2010 and January, 2016. The patientswere divided into two groups:a uterine adenomyosisgroup and a non-adenomyosis group. Patient demographics, type of surgery, histopathology, stage of endometrial cancer, adjuvant treatment, and survival outcomes were compared. Results: A total 350 patients were enrolled, with 132 (37.71%) in the adenomyosis group and 218 (62.29%) in the nonadenomyosis group. Deep myometrial invasion and lymphovascular space invasion (LVSI) were more commonly found among patients who had no adenomyosis compared to those with adenomyosis(52.8% vs 39.4%, P=0.02 and 53.2% vs. 38.6%, P=0.01). There were no significant differences in terms of five-year recurrence-free survival (HR=1.47; 95%CI 0.88-2.44) and five-year overall survival (HR=0.81; 95%CI 0.43-1.53) between the two comparison groups. Conclusion: Coexisting uterine adenomyosis in endometrial cancer wasassociated withdeep myometrial invasion and LVSI but did not have significant impact on survival.

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“…All studies were retrospective [19,20,21,22,23,24,25,26,27]. In accordance with the selection criteria, only data from the VBT treatment arms were extracted and considered for the analysis.…”

Section: Resultsmentioning

confidence: 99%

The role of vaginal brachytherapy in stage I endometrial serous cancer: a systematic review

Lancellotta

Felice

Vicenzi

et al. 2020

jcb

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Purpose: Serous adenocarcinoma (uterine serous carcinoma-USC) is a rare and aggressive histologic subtype of endometrial cancer, with a high-rate of recurrence and poor prognosis. The adjuvant treatment for stage I patients is unclear. The purpose of this study was to evaluate the outcomes of stage I USC treated exclusively with chemotherapy plus vaginal brachytherapy (VBT). Material and methods: A systematic research using PubMed, Scopus, and Cochrane library was conducted to identify full articles evaluating the efficacy of VBT in patients with stage I USC. A search in ClinicalTrials.gov was performed in order to detect ongoing or recently completed trials, and in PROSPERO for searching ongoing or recently completed systematic reviews. Results: All studies were retrospective and 364 of evaluated patients were found. The average local control was 97.5% (range, 91-100%), the disease free-survival was 88% (range, 82-94%), the overall survival was 93% (range, 72-100%), the specific cancer survival was 89.4% (range, 84.8-94%), and the G3-G4 toxicity was 0-8%. Conclusions: These data support the concept that in adequately selected patients, VBT alone may be a suitable radiotherapy technique in women with stage I USC who underwent surgical staging and received adjuvant chemotherapy.

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The role of adjuvant therapy in stage IA serous and clear cell uterine cancer: A multi-institutional pooled analysis

Cited by 34 publications

References 31 publications

WITHDRAWN: Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

WITHDRAWN: Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

Impact of Coexisting Uterine Adenomyosis on the Survival Outcome of Patients with Endometrial Cancer: A Retrospective Cohort Study

The role of vaginal brachytherapy in stage I endometrial serous cancer: a systematic review

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