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• W2117566329 abstract "Purpose/Objective: Patients with pathologic stage III endometrial cancer confined to the pelvis are often treated with pelvic radiotherapy (RT). However, data regarding predictors of outcomes is limited. This retrospective study assesses prognostic factors and patterns of recurrence in these patients. Materials/Methods: Between 1990 and 2003, 121 patients with pathologic FIGO stage III endometrial adenocarcinoma confined to the pelvis were treated at a single institution. Adjuvant RT was delivered to 76 patients (62.8%). The influence on outcome of age, histologic subtype and grade, lymphovascular invasion, depth of myometrial invasion, involvement of the lower uterine segment, cervix, uterine serosa, adnexa, and nodes, number of extrauterine sites involved, resection margin status, and adjuvant RT, chemotherapy, and hormonal therapy were evaluated. In addition, age, body mass index (BMI), history of smoking, diabetes, hypertension, inflammatory bowel disease, previous bowel obstruction, previous abdominal and pelvic surgery, radiation dose, beam energy, field arrangement and size, and adjuvant chemotherapy were evaluated as potential predictors of toxicity. Results: Median follow-up was 38.7 months. Five-year actuarial overall survival is significantly improved in patients treated with adjuvant RT (68.0%) compared those with resection alone (50.3%; p = 0.029). Five-year disease-free survival in patients treated with or without adjuvant RT was 66.5% and 36.9%, respectively (p = 0.004). Age, histologic grade, uterine serosal invasion, adnexal involvement, number of extrauterine sites, and treatment with adjuvant RT predicted for improved survival in univariate analysis. Cox regression multivariate analysis revealed that only histologic grade, uterine serosal invasion, and treatment with adjuvant RT were independent predictors of survival. Five-year actuarial local control improved significantly with the delivery of adjuvant RT (73.7% versus 49.1%; p = 0.011). Predictors of local control included depth of myometrial invasion, uterine serosal invasion, adnexal involvement, resection margin status, and treatment with adjuvant RT in univariate analysis. Depth of myometrial invasion and treatment with adjuvant RT were independent predictors of local control in multivariate analysis. The overall 5-year actuarial distant control was 65.2%. In univariate analysis, histologic subtype and grade, and uterine serosal invasion were significant predictors of distant control. However, only histologic subtype and uterine serosal invasion were independent predictors of distant control in multivariate analysis. Neither treatment with adjuvant chemotherapy nor hormonal therapy were significant predictors for improved survival, local control, or distant control. Acute and late grade 3 or higher toxicity was observed in four patients (5.3%) and two patients (2.9%), respectively, treated with adjuvant RT. BMI, history of previous pelvic surgery, field arrangement, and treatment with adjuvant chemotherapy were predictors of the development of acute toxicity. In addition, history of previous pelvic surgery and field arrangement were significant predictors of late toxicity. No treatment-related deaths were observed. Conclusions: Multiple prognostic factors predicting for the outcome of pathologic stage III endometrial cancer patients were identified in this analysis. In particular, delivery of adjuvant RT is a significant independent predictor for improved survival and local control. Pelvic RT should always be considered in the management of these patients." @default.
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• W2117566329 date "2005-10-01" @default.
• W2117566329 modified "2023-09-27" @default.
• W2117566329 title "Predictors of Outcome and Patterns of Failure in Patients with Pathologic Stage III Endometrial Cancer Confined to the Pelvis" @default.
• W2117566329 doi "https://doi.org/10.1016/j.ijrobp.2005.07.365" @default.
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