1Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
4Department of Radiation Oncology, Asan Medical Center, Seoul, Korea
5Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
6Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
7Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
8Department of Radiation Oncology, Inha University School of Medicine, Incheon, Korea
9Department of Radiation Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea
10Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
11Department of Radiation Oncology, Cheil General Hospital and Women’s Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
12Department of Radiation Oncology Korea University College of Medicine, Seoul, Korea
13Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Korea
14Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
15Department of Radiation Oncology, Dong-A University School of Medicine, Busan, Korea
16Department of Radiation Oncology, University of Wonkwang School of Medicine, Iksan, Korea
17Department of Radiation Oncology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
18Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Copyright © 2016 by the Korean Cancer Association
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Characteristic | All (n=93) | RT alone (n=57) | CTRT (n=36) | p-value |
---|---|---|---|---|
Age, median (range, yr) | 51 (25-83) | 50 (25-83) | 54 (35-75) | 0.281 |
Age (yr) | ||||
< 60 | 74 (79.6) | 46 (80.7) | 28 (77.8) | 0.733 |
≥ 60 | 19 (20.4) | 11 (19.3) | 8 (22.2) | |
Grade | ||||
I | 41 (44.1) | 28 (49.1) | 13 (36.1) | 0.291 |
II | 30 (32.3) | 15 (26.3) | 15 (41.7) | |
III | 20 (21.5) | 12 (21.1) | 8 (22.2) | |
Unknown | 2 (2.2) | 2 (3.5) | 0 | |
Serosal involvement | ||||
Negative | 70 (75.3) | 44 (77.2) | 26 (72.2) | 0. 361 |
Positive | 21 (22.6) | 11 (19.3) | 10 (27.8) | |
Unknown | 2 (2.2) | 2 (3.5) | 0 | |
Adnexal involvement | ||||
Negative | 16 (17.2) | 11 (19.3) | 5 (13.9) | 0.501 |
Positive | 77 (82.8) | 46 (80.7) | 31 (86.1) | |
Lymphovascular involvement | ||||
Negative | 59 (63.4) | 38 (66.7) | 21 (58.3) | 0.214 |
Positive | 20 (21.5) | 9 (15.8) | 11 (30.6) | |
Unknown | 14 (15.1) | 10 (17.5) | 4 (15.1) | |
Tumor sizea), mean (range, cm) | 4.6 (0.4-12) | 4.4 (1.5-12) | 5.0 (0.4-10.2) | 0.327 |
Lymph node dissection | ||||
Pelvic LN dissection | 77 (82.8) | 44 (77.2) | 33 (91.7) | 0.072 |
Paraaortic LN dissection | 31 (33.3) | 12 (21.1) | 19 (52.8) | 0.002 |
Type of external beam radiotherapy | ||||
Whole pelvis | 89 (95.7) | 54 (94.7) | 35 (97.2) | 0.500 |
Whole pelvis+paraaortic field | 2 (2.2) | 1 (1.8) | 1 (2.8) | |
Whole abdomen | 2 (2.2) | 2 (3.5) | 0 | |
Additional vaginal brachytherapy | ||||
No | 72 (77.4) | 46 (80.7) | 26 (72.2) | 0.341 |
Yes | 21 (21.6) | 11 (19.3) | 10 (27.8) | |
CTRT sequence | ||||
Concurrent | 30 (83.3) | |||
Sequential | 6 (16.7) |
Treatment | RT alone (n=57) | CTRT (n=36) | p-valuea) |
---|---|---|---|
Locoregional recurrence | - | 2 (18.2) | - |
Pelvic cavity only | - | 1 | |
Pelvic LN+vagina | - | 1 | |
Pelvic LN+paraaortic LN | 1 (12.5) | - | |
Distant metastasis | 6 (75.0) | 9 (81.8) | - |
Peritoneal seeding only | 2 | 2 | |
Solid organs (liver, lung, vulva, etc.) | |||
Lung only | 1 | 4 | |
Lung+other organ | 1 | 1 | |
Vulva | 1 | 1 | |
Other or multiple (liver, abd wall, and spleen) | 1 | 1 | |
Combined LRR and DM | 1 (12.5) | - | - |
Total recurrence | 8 (14.0) | 11 (30.6) | 0.054 |
Parameter |
Disease-free survival |
Overall survival |
||
---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | |
Age (< 60 yr vs. ≥ 60 yr) | - | 0.340 | 5.83 (1.15-29.61) | 0.034 |
Grade (G1 vs. G2G3) | - | 0.903 | - | 0.834 |
LVI (no vs. yes) | - | 0.884 | - | 0.437 |
No. of risk factorsa) (< 2 vs. ≥ 2) | 5.45 (2.12-13.98) | < 0.001 | - | 0.093 |
RT alone vs. CTRT | - | 0.488 | - | 0.177 |
Characteristic | All (n=93) | RT alone (n=57) | CTRT (n=36) | p-value |
---|---|---|---|---|
Age, median (range, yr) | 51 (25-83) | 50 (25-83) | 54 (35-75) | 0.281 |
Age (yr) | ||||
< 60 | 74 (79.6) | 46 (80.7) | 28 (77.8) | 0.733 |
≥ 60 | 19 (20.4) | 11 (19.3) | 8 (22.2) | |
Grade | ||||
I | 41 (44.1) | 28 (49.1) | 13 (36.1) | 0.291 |
II | 30 (32.3) | 15 (26.3) | 15 (41.7) | |
III | 20 (21.5) | 12 (21.1) | 8 (22.2) | |
Unknown | 2 (2.2) | 2 (3.5) | 0 | |
Serosal involvement | ||||
Negative | 70 (75.3) | 44 (77.2) | 26 (72.2) | 0. 361 |
Positive | 21 (22.6) | 11 (19.3) | 10 (27.8) | |
Unknown | 2 (2.2) | 2 (3.5) | 0 | |
Adnexal involvement | ||||
Negative | 16 (17.2) | 11 (19.3) | 5 (13.9) | 0.501 |
Positive | 77 (82.8) | 46 (80.7) | 31 (86.1) | |
Lymphovascular involvement | ||||
Negative | 59 (63.4) | 38 (66.7) | 21 (58.3) | 0.214 |
Positive | 20 (21.5) | 9 (15.8) | 11 (30.6) | |
Unknown | 14 (15.1) | 10 (17.5) | 4 (15.1) | |
Tumor size |
4.6 (0.4-12) | 4.4 (1.5-12) | 5.0 (0.4-10.2) | 0.327 |
Lymph node dissection | ||||
Pelvic LN dissection | 77 (82.8) | 44 (77.2) | 33 (91.7) | 0.072 |
Paraaortic LN dissection | 31 (33.3) | 12 (21.1) | 19 (52.8) | 0.002 |
Type of external beam radiotherapy | ||||
Whole pelvis | 89 (95.7) | 54 (94.7) | 35 (97.2) | 0.500 |
Whole pelvis+paraaortic field | 2 (2.2) | 1 (1.8) | 1 (2.8) | |
Whole abdomen | 2 (2.2) | 2 (3.5) | 0 | |
Additional vaginal brachytherapy | ||||
No | 72 (77.4) | 46 (80.7) | 26 (72.2) | 0.341 |
Yes | 21 (21.6) | 11 (19.3) | 10 (27.8) | |
CTRT sequence | ||||
Concurrent | 30 (83.3) | |||
Sequential | 6 (16.7) |
Treatment | RT alone (n=57) | CTRT (n=36) | p-value |
---|---|---|---|
Locoregional recurrence | - | 2 (18.2) | - |
Pelvic cavity only | - | 1 | |
Pelvic LN+vagina | - | 1 | |
Pelvic LN+paraaortic LN | 1 (12.5) | - | |
Distant metastasis | 6 (75.0) | 9 (81.8) | - |
Peritoneal seeding only | 2 | 2 | |
Solid organs (liver, lung, vulva, etc.) | |||
Lung only | 1 | 4 | |
Lung+other organ | 1 | 1 | |
Vulva | 1 | 1 | |
Other or multiple (liver, abd wall, and spleen) | 1 | 1 | |
Combined LRR and DM | 1 (12.5) | - | - |
Total recurrence | 8 (14.0) | 11 (30.6) | 0.054 |
Parameter | Disease-free survival |
Overall survival |
||
---|---|---|---|---|
5-Year (%) | p-value | 5-Year (%) | p-value | |
Age (< 60 yr vs. ≥ 60 yr) | ||||
< 60 | 86.6 | < 0.001 | 96.7 | 0.028 |
≥ 60 | 48.9 | 81.4 | ||
Grade (G1 vs. G2/3) | ||||
G1 | 90.0 | 0.029 | 94.4 | 0.387 |
G2/G3 | 68.9 | 93.3 | ||
LVI | ||||
No | 83.2 | 0.041 | 91.9 | 0.699 |
Yes | 57.9 | 94.4 | ||
Serosal involvement | ||||
No | 81.5 | 0.180 | 91.8 | 0.747 |
Yes | 67.2 | 100 | ||
Adnexal involvement | ||||
No | 73.8 | 0.790 | 100 | 0.991 |
Yes | 79.1 | 92.5 | ||
Size (diameter, cm) | ||||
≤ 5 | 84.0 | 0.175 | 95.5 | 0.482 |
> 5 | 77.3 | 89.4 | ||
Adjuvant treatment | ||||
RT alone | 82.4 | 0.130 | 91.9 | 0.262 |
CTRT | 74.1 | 96.3 |
Parameter | Disease-free survival |
Overall survival |
||
---|---|---|---|---|
HR (95% CI) | p-value | HR (95% CI) | p-value | |
Age (< 60 yr vs. ≥ 60 yr) | - | 0.340 | 5.83 (1.15-29.61) | 0.034 |
Grade (G1 vs. G2G3) | - | 0.903 | - | 0.834 |
LVI (no vs. yes) | - | 0.884 | - | 0.437 |
No. of risk factors |
5.45 (2.12-13.98) | < 0.001 | - | 0.093 |
RT alone vs. CTRT | - | 0.488 | - | 0.177 |
Values are presented as number (%) unless otherwise indicated. RT, radiotherapy; CTRT, chemoradiotherapy; LN, lymph node. Data were available in 70 patients with measurable primary tumor.
Values are presented as number (%). RT, radiotherapy; CTRT, chemoradiotherapy; LN, lymph node; LRR, locoregional recurrence; DM, distant metastasis. Chi-square test.
LVI, lymphovascular involvement; RT, radiotherapy; CTRT, chemoradiotherapy.
HR, hazard ratio; CI, confidence interval; LVI, lymphovascular space invasion; RT, radiotherapy; CTRT, chemoradiotherapy. Risk factor: age ≥ 60 years or ≥ G2 or LVI.