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• W2080784195 abstract "To analyze sites of failure, recurrence-free survival (RFS), and overall survival (OS) in patients with node-positive endometrial cancer treated with adjuvant radiotherapy (RT). We identified 81 patients with FIGO Stage IIIC endometrial cancer treated from 1995 to 2005. Exclusions included carcinosarcoma (6), no follow-up (6), incomplete RT (2), no RT (5), and second cancer prior to treatment (1). The remaining 61 patients had a TAH/BSO and lymph node sampling (31) or dissection (30); 4 had gross residual disease, and 2 had positive surgical margins. All received external-beam RT to the pelvis (P) (39), pelvis and para-aortic nodes (PAN) (15), or whole abdomen (7). Thirty-eight patients received vaginal brachytherapy, and 42 received chemotherapy, of who 40 received Taxol. The median RT dose was 45 Gy for P and PAN and 30 Gy for whole abdomen. Kaplan-Meier RFS and OS rates were compared by the log rank test. Cox multivariate regression (MVA) was used to analyze predictors of survival. Characteristics included: median age, 60 years; median tumor size, 4.3cm; histology, endometrioid (Eh) (62%), papillary serous (15%), clear cell (8%) and mixed (15%); grade 2 or 3, 89%; lymphovascular invasion, 66%; >50% myometrial invasion (MMI), 64%; 51 patients had positive P nodes only, 4 had positive PAN only, and 6 had both. The median number of recovered nodes was 10 (range 1-36), and the median number of positive nodes was 1 (range 1-9). The median follow-up time for survivors was 54 months. The 3-year RFS was 62% and OS was 69%. The risk of recurrence and mortality was significantly higher for non-Eh (p < 0.001 for both) and grade 3 tumors (p = 0.001 for RFS; p = 0.005 for OS). MVA independent predictors were for OS: Eh (HR 0.08, p = 0.001), MMI >10% (HR 1.35; p = 0.003), and Taxol (HR 0.08; p = 0.001); and were similar for RFS: Eh (HR 0.26, p = 0.02), MMI (HR 1.25, p = 0.01), and Taxol (HR 0.16, p = 0.006). Grade, LVI, lymph node dissection, extent of radiation or number of positive nodes did not predict either RFS or OS. Twenty-one recurrences included local (3), regional (7), distant (5), and both regional and distant (6) at a median 14 months after diagnosis. Only 5 patients (8%) recurred within an RT field. The estimated incidence of an infield recurrence was 8.4% at 2 years. Ten patients (24%) recurred distantly after chemotherapy. Adjuvant RT provides excellent local and regional control in patients with FIGO Stage IIIC endometrial cancer. Regional and distant recurrences outside the radiation field account for a significant proportion of relapses. The use of Taxol was a significant predictor of RFS and OS, suggesting a potential benefit of combined-modality therapy. New therapeutic approaches are necessary to increase survival rates." @default.
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• W2080784195 date "2008-09-01" @default.
• W2080784195 modified "2023-10-01" @default.
• W2080784195 title "Clinical Outcome following Adjuvant Radiotherapy for Node-positive Endometrial Cancer" @default.
• W2080784195 doi "https://doi.org/10.1016/j.ijrobp.2008.06.1209" @default.
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