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 Scopus citations

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 1 2013
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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