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J Surg Oncol. 2017 Sep;116(4):482-491. doi: 10.1002/jso.24690. Epub 2017 May 25.

Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer.

Author information

1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
2
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
3
Department of Radiation Oncology, University of Southern California, Los Angeles, California.

Abstract

BACKGROUND AND OBJECTIVES:

To examine characteristics and survival outcome of women with endometrial cancer who declined postoperative radiotherapy.

METHODS:

A retrospective study was conducted to examine surgically-treated grade 1-2 stage IB and grade 3 stage IA-IB endometrioid endometrial cancer in the Surveillance, Epidemiology, and End Results Program between 1983 and 2013 (n = 10 613). Associations of patient declination for guideline-based postoperative radiotherapy and clinico-pathological demographics or survival outcome were examined on multivariable analysis.

RESULTS:

There were 323 (3.0%) women who declined adjuvant radiotherapy. Women who declined postoperative radiotherapy were more likely to be older, White, Western U.S. residents, and register in recent years (all, adjusted-P < 0.05). On multivariable analysis, patient declination for guideline-based postoperative radiotherapy remained an independent prognostic factor for decreased endometrial cancer-specific survival in unstaged grade 1-2 stage IB or staged/unstated grade 3 stage IA-IB diseases (adjusted-hazard ratio 1.84, 95% confidence interval 1.34-2.51, P = 0.001). Association of patient declination for guideline-based postoperative radiotherapy and decreased overall survival remained independent in the entire cohort on multivariable analysis (adjuvant-hazard ratio 1.71, 95% confidence interval 1.44-2.02, P < 0.001).

CONCLUSIONS:

Our study suggested that patient compliance to guideline-based postoperative radiotherapy is a prognostic factor for women with stage I endometrioid endometrial cancer.

KEYWORDS:

adjuvant radiotherapy; compliance; endometrial cancer; survival outcome

PMID:
28543055
DOI:
10.1002/jso.24690
[Indexed for MEDLINE]

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