Article ; Online: Adjuvant chemotherapy and radiation for patients with high-risk stage I endometrial cancer treated with curative intent surgery: impact on recurrence and survival.
2022 Volume 32, Issue 4, Page(s) 508–516
Abstract: Background: Survival benefits of post-operative systemic and radiation therapy in high-risk stage I endometrial cancer are uncertain.: Objective: To compare recurrence patterns and survival outcomes of post-surgical treatment in patients with high- ... ...
Abstract | Background: Survival benefits of post-operative systemic and radiation therapy in high-risk stage I endometrial cancer are uncertain. Objective: To compare recurrence patterns and survival outcomes of post-surgical treatment in patients with high-risk stage I endometrial cancer and to determine whether adjuvant therapy significantly improves outcomes. Methods: High-risk stage I endometrial cancer was defined as either stage IB grade 3 endometrioid histology or myoinvasive non-endometrioid histology. Consecutive patients diagnosed between January 2000 and December 2010 in eight cancer centers were included. Patients, disease, and treatment characteristics were summarized by descriptive statistics. Overall survival, disease-specific survival, and relapse-free survival were examined using Cox's proportional hazards regression and log-rank test. Survival curves were estimated using the Kaplan-Meier method. Results: Of 2317 patients with stage I endometrial cancer, 414 patients had high-risk disease. Use of chemotherapy did not improve overall survival (relative risk (RR) 0.70, 95% CI 0.46 to 1.14, p=0.13) or disease-specific survival (RR 1.06, 95% CI 0.61 to 1.85, p=0.84). Significant improvement in recurrence-free survival was observed in patients who received chemotherapy (RR 0.61, 95% CI 0.39 to 0.95, p=0.03). Use of radiation therapy did not improve overall survival, recurrence-free survival, or disease-specific survival. Patients who received four cycles or fewer of chemotherapy versus five to six cycles had similar overall survival, disease-specific survival, and recurrence-free survival. Conclusions: Post-operative chemotherapy or radiation in stage I high-risk endometrial cancer is not associated with improved cancer-specific or overall survival. More than four cycles of chemotherapy did not improve survival compared with four cycles or fewer. |
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MeSH term(s) | Chemotherapy, Adjuvant ; Endometrial Neoplasms/drug therapy ; Endometrial Neoplasms/radiotherapy ; Endometrial Neoplasms/surgery ; Female ; Humans ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Radiotherapy, Adjuvant/methods ; Retrospective Studies |
Language | English |
Publishing date | 2022-04-04 |
Publishing country | England |
Document type | Journal Article |
ZDB-ID | 1070385-8 |
ISSN | 1525-1438 ; 1048-891X |
ISSN (online) | 1525-1438 |
ISSN | 1048-891X |
DOI | 10.1136/ijgc-2021-003087 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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