Adjuvant radiation therapy for patients with type II endometrial carcinoma: Impact on tumor recurrence and survival

Raphael Yechieli, Nabila Rasool, Jared R. Robbins, Chad M. Cogan, Mohamed A. Elshaikh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose/Objective: The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. The objective of this study was to determine the effect of adjuvant radiation therapy (RT) on recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival in patients with early-stage type II endometrial carcinoma. Materials and Methods: In this institutional review board-approved study, our database of 1450 patients with endometrial cancer was reviewed. Seventy-nine surgically staged patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stages I and II serous and clear cell carcinoma were treated from 1991 to 2010. These patients were then divided into 2 groups; one group received adjuvant RT, and the other group included patients who did not receive adjuvant RT. Results: The median age of the study cohort is 65 years, and the median follow-up is 47 months. Thirty-nine patients (49%) received adjuvant RT, and 40 patients did not. The 5-year RFS was significantly improved in patients who received RT (84% vs 58%; P = 0.002). Similarly, 5-year DSS was significantly improved in patients who received RT (87% vs 58%; P = 0.023) with a trend toward improved 5-year overall survival (74% vs 58%; P = 0.088). On multivariate analysis, lack of angiolymphatic invasion (P < 0.001 and P < 0.001), adjuvant RT (P < 0.001 and P = 0.004), and lack of lower uterine segment involvement (P = 0.007 and P = 0.009) were independent predictors of improved RFS and DSS, respectively. Conclusions: In the current study of surgically staged patients with type II endometrial carcinoma International Federation of Gynecology and Obstetrics stages I and II, adjuvant radiation therapy with or without chemotherapy resulted in a significant improvement in recurrence-free and disease-specific survival.

Original languageEnglish (US)
Pages (from-to)763-768
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume23
Issue number4
DOIs
StatePublished - May 2013
Externally publishedYes

Fingerprint

Endometrial Neoplasms
Radiotherapy
Recurrence
Survival
Neoplasms
Disease-Free Survival
Gynecology
Obstetrics
Research Ethics Committees
Hysterectomy
Cohort Studies
Multivariate Analysis
Databases
Carcinoma
Drug Therapy

Keywords

  • Chemotherapy
  • Clear cell
  • Endometrial carcinoma
  • Radiation treatment
  • Type II
  • Uterine serous

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Adjuvant radiation therapy for patients with type II endometrial carcinoma : Impact on tumor recurrence and survival. / Yechieli, Raphael; Rasool, Nabila; Robbins, Jared R.; Cogan, Chad M.; Elshaikh, Mohamed A.

In: International Journal of Gynecological Cancer, Vol. 23, No. 4, 05.2013, p. 763-768.

Research output: Contribution to journalArticle

Yechieli, Raphael ; Rasool, Nabila ; Robbins, Jared R. ; Cogan, Chad M. ; Elshaikh, Mohamed A. / Adjuvant radiation therapy for patients with type II endometrial carcinoma : Impact on tumor recurrence and survival. In: International Journal of Gynecological Cancer. 2013 ; Vol. 23, No. 4. pp. 763-768.
@article{6ab7456d42d642f1a2094f1a09f844b5,
title = "Adjuvant radiation therapy for patients with type II endometrial carcinoma: Impact on tumor recurrence and survival",
abstract = "Purpose/Objective: The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. The objective of this study was to determine the effect of adjuvant radiation therapy (RT) on recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival in patients with early-stage type II endometrial carcinoma. Materials and Methods: In this institutional review board-approved study, our database of 1450 patients with endometrial cancer was reviewed. Seventy-nine surgically staged patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stages I and II serous and clear cell carcinoma were treated from 1991 to 2010. These patients were then divided into 2 groups; one group received adjuvant RT, and the other group included patients who did not receive adjuvant RT. Results: The median age of the study cohort is 65 years, and the median follow-up is 47 months. Thirty-nine patients (49{\%}) received adjuvant RT, and 40 patients did not. The 5-year RFS was significantly improved in patients who received RT (84{\%} vs 58{\%}; P = 0.002). Similarly, 5-year DSS was significantly improved in patients who received RT (87{\%} vs 58{\%}; P = 0.023) with a trend toward improved 5-year overall survival (74{\%} vs 58{\%}; P = 0.088). On multivariate analysis, lack of angiolymphatic invasion (P < 0.001 and P < 0.001), adjuvant RT (P < 0.001 and P = 0.004), and lack of lower uterine segment involvement (P = 0.007 and P = 0.009) were independent predictors of improved RFS and DSS, respectively. Conclusions: In the current study of surgically staged patients with type II endometrial carcinoma International Federation of Gynecology and Obstetrics stages I and II, adjuvant radiation therapy with or without chemotherapy resulted in a significant improvement in recurrence-free and disease-specific survival.",
keywords = "Chemotherapy, Clear cell, Endometrial carcinoma, Radiation treatment, Type II, Uterine serous",
author = "Raphael Yechieli and Nabila Rasool and Robbins, {Jared R.} and Cogan, {Chad M.} and Elshaikh, {Mohamed A.}",
year = "2013",
month = "5",
doi = "10.1097/IGC.0b013e31828b15cb",
language = "English (US)",
volume = "23",
pages = "763--768",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Adjuvant radiation therapy for patients with type II endometrial carcinoma

T2 - Impact on tumor recurrence and survival

AU - Yechieli, Raphael

AU - Rasool, Nabila

AU - Robbins, Jared R.

AU - Cogan, Chad M.

AU - Elshaikh, Mohamed A.

PY - 2013/5

Y1 - 2013/5

N2 - Purpose/Objective: The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. The objective of this study was to determine the effect of adjuvant radiation therapy (RT) on recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival in patients with early-stage type II endometrial carcinoma. Materials and Methods: In this institutional review board-approved study, our database of 1450 patients with endometrial cancer was reviewed. Seventy-nine surgically staged patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stages I and II serous and clear cell carcinoma were treated from 1991 to 2010. These patients were then divided into 2 groups; one group received adjuvant RT, and the other group included patients who did not receive adjuvant RT. Results: The median age of the study cohort is 65 years, and the median follow-up is 47 months. Thirty-nine patients (49%) received adjuvant RT, and 40 patients did not. The 5-year RFS was significantly improved in patients who received RT (84% vs 58%; P = 0.002). Similarly, 5-year DSS was significantly improved in patients who received RT (87% vs 58%; P = 0.023) with a trend toward improved 5-year overall survival (74% vs 58%; P = 0.088). On multivariate analysis, lack of angiolymphatic invasion (P < 0.001 and P < 0.001), adjuvant RT (P < 0.001 and P = 0.004), and lack of lower uterine segment involvement (P = 0.007 and P = 0.009) were independent predictors of improved RFS and DSS, respectively. Conclusions: In the current study of surgically staged patients with type II endometrial carcinoma International Federation of Gynecology and Obstetrics stages I and II, adjuvant radiation therapy with or without chemotherapy resulted in a significant improvement in recurrence-free and disease-specific survival.

AB - Purpose/Objective: The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. The objective of this study was to determine the effect of adjuvant radiation therapy (RT) on recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival in patients with early-stage type II endometrial carcinoma. Materials and Methods: In this institutional review board-approved study, our database of 1450 patients with endometrial cancer was reviewed. Seventy-nine surgically staged patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stages I and II serous and clear cell carcinoma were treated from 1991 to 2010. These patients were then divided into 2 groups; one group received adjuvant RT, and the other group included patients who did not receive adjuvant RT. Results: The median age of the study cohort is 65 years, and the median follow-up is 47 months. Thirty-nine patients (49%) received adjuvant RT, and 40 patients did not. The 5-year RFS was significantly improved in patients who received RT (84% vs 58%; P = 0.002). Similarly, 5-year DSS was significantly improved in patients who received RT (87% vs 58%; P = 0.023) with a trend toward improved 5-year overall survival (74% vs 58%; P = 0.088). On multivariate analysis, lack of angiolymphatic invasion (P < 0.001 and P < 0.001), adjuvant RT (P < 0.001 and P = 0.004), and lack of lower uterine segment involvement (P = 0.007 and P = 0.009) were independent predictors of improved RFS and DSS, respectively. Conclusions: In the current study of surgically staged patients with type II endometrial carcinoma International Federation of Gynecology and Obstetrics stages I and II, adjuvant radiation therapy with or without chemotherapy resulted in a significant improvement in recurrence-free and disease-specific survival.

KW - Chemotherapy

KW - Clear cell

KW - Endometrial carcinoma

KW - Radiation treatment

KW - Type II

KW - Uterine serous

UR - http://www.scopus.com/inward/record.url?scp=84879943259&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879943259&partnerID=8YFLogxK

U2 - 10.1097/IGC.0b013e31828b15cb

DO - 10.1097/IGC.0b013e31828b15cb

M3 - Article

C2 - 23485931

AN - SCOPUS:84879943259

VL - 23

SP - 763

EP - 768

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 4

ER -