Cancer Research and Treatment

Original Articles

Adjuvant Treatment after Surgery in Stage IIIA Endometrial Adenocarcinoma: Mee Sun Yoon, Seung Jae Huh, Hak Jae Kim, Young Seok Kim, Yong Bae Kim, Joo-Young Kim, Jong-Hoon Lee, Hun Jung Kim, Jihye Cha, Jin Hee Kim, Juree Kim, Won Sup Yoon, Jin Hwa Choi, Mison Chun, Youngmin Choi, Kang Kyoo Lee, Myungsoo Kim, Jae-Uk Jeong, Sei Kyung Chang, Won Park; Cancer Res Treat. 2016;48(3):1074-1083. Published online October 29, 2015; DOI: https://doi.org/10.4143/crt.2015.356

Purpose
We evaluated the role of adjuvant therapy in stage IIIA endometrioid adenocarcinoma patients who underwent surgery followed by radiotherapy (RT) alone or chemoradiotherapy (CTRT) according to risk group. Materials and Methods A multicenter retrospective study was conducted including patients with surgical stage IIIA endometrial cancertreated by radical surgery and adjuvant RT or CTRT. Disease-free survival (DFS) and overall survival (OS) were analyzed.
Results
Ninety-three patients with stage IIIA disease were identified. Nineteen patients (20.4%) experienced recurrence, mostly distant metastasis (17.2%). Combined CTRT did not affect DFS (74.1% vs. 82.4%, p=0.130) or OS (96.3% vs. 91.9%, p=0.262) in stage IIIA disease compared with RT alone. Patients with age ≥ 60 years, grade G2/3, and lymphovascular space involvement had a significantly worse DFS and those variables were defined as risk factors. The high-risk group showed a significant reduction in 5-year DFS (≥ 2 risk factors) (49.0% vs. 88.0%, p < 0.001) compared with the low-risk group (< 2). Multivariate analysis confirmed that more than one risk factor was the only predictor of worse DFS (hazard ratio, 5.45; 95% confidence interval, 2.12 to 13.98; p < 0.001). Of patients with no risk factors, a subset treated with RT alone showed an excellent 5-year DFS and OS (93.8% and 100%, respectively). Conclusion We identified a low-risk subset of stage IIIA endometrioid adenocarcinoma patients who might be reasonable candidates for adjuvant RT alone. Further randomized studies are needed to determine which subset might benefit from combined CTRT.

Citations

Citations to this article as recorded by

Practice patterns and survival in FIGO 2009 stage 3B endometrial cancer
Jessica Jou, Lindsey Charo, Marianne Hom-Tedla, Katherine Coakley, Pratibha Binder, Cheryl Saenz, Ramez N. Eskander, Michael McHale, Steven Plaxe
Gynecologic Oncology.2021; 163(2): 299. CrossRef
Treatment strategies for endometrial cancer: current practice and perspective
Yeh C. Lee, Stephanie Lheureux, Amit M. Oza
Current Opinion in Obstetrics & Gynecology.2017; 29(1): 47. CrossRef

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Results of Definitive Radiation Therapy in Adenosquamous Cell Carcinoma of the Uterine Cervix: Sang Wook Lee, Chang Ok Suh, Eun Ji Chung, Gwi Eon Kim, Kyung Ran Park, Kang Kyoo Lee, Ik Jae Lee, Tchan Kyu Park, Jaewook Kim, Jong Taek Park, Jae Uk Shim, Joon Oh Park; J Korean Cancer Assoc. 2001;33(1):21-26.

Abstract PDF: PURPOSE
To define the clinical features and pattern of failure and to evaluate the results of radiation treatment in of adenosquamous cell carcinoma of the uterine cervix.
MATERIALS AND METHODS
From Jun. 1981 to Dec. 1997, 43 patients with adenosquamous cell carcinoma of the uterine cervix were retrospectively analyzed external radiation treatment and HDR-ICR from Yonsei cancer center and Wonju cristian hospital. The median age was 51. Stage distribution according to FIGO were stage 1b in 10, 2a in 5, 2b in 18, 3b in 9, 4a in 1. Median follow-up period was 41 months.
RESULTS
Overall survival rate and disease free survival rate were 57.2% and 60.2%. Complete response rate was 86.0%. Locoregional failure was observed in seven patients.
CONCLUSION
Major pattern of failure was locoregional failure. Adenosquamous cell carcinoma was not more aggressive than other pathologic types.

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