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J Gynecol Oncol. 2019 May;30(3):e44. doi: 10.3802/jgo.2019.30.e44.

Survival outcomes of adjuvant radiotherapy and chemotherapy in women with stage I serous papillary and clear cell carcinoma of the endometrium: a Korean multicenter study.

Author information

1
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
2
Department of Obstetrics and Gynecology, Pusan National University Hospital, Busan, Korea.
3
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
4
Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Korea.
5
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
6
Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Korea.
7
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
8
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ybkimlh@snubh.org.

Abstract

OBJECTIVE:

To compare the survival outcomes of adjuvant radiotherapy and chemotherapy in women with uterine-confined endometrial cancer with uterine papillary serous carcinoma (UPSC) or clear cell carcinoma (CCC).

METHODS:

Medical records of 80 women who underwent surgical staging for endometrial cancer were retrospectively reviewed. Stage I UPSC and CCC were pathologically confirmed after surgery. Survival outcomes were compared between the adjuvant radiotherapy and chemotherapy groups.

RESULTS:

Fifty-four (67.5%) and 26 (32.5%) women had UPSC and CCC, respectively. Adjuvant therapy was administered to 59/80 (73.8%) women (25 radiotherapy and 34 chemotherapy). High preoperative serum cancer antigen-125 level (25.1±20.2 vs. 11.5±6.5 IU/mL, p<0.001), open surgery (71.2% vs. 28.6%, p=0.001), myometrial invasion (MI) ≥1/2 (33.9% vs. 0, p=0.002), and lymphovascular space invasion (LVSI; 28.8% vs. 4.8%, p=0.023) were frequent in women who received adjuvant therapy compared to those who did not. However, the histologic type, MI ≥1/2, and LVSI did not differ between women who received adjuvant radiotherapy and those who received chemotherapy. The 5-year progression-free survival (78.9% vs. 80.1%, p>0.999) and overall survival (77.5% vs. 87.8%, p=0.373) rates were similar between the groups. Neither radiotherapy (hazard ratio [HR]=1.810; 95% confidence interval [CI]=0.297-11.027; p=0.520) nor chemotherapy (HR=1.638; 95% CI=0.288-9.321; p=0.578) after surgery was independently associated with disease recurrence.

CONCLUSION:

Our findings showed similar survival outcomes for adjuvant radiotherapy and chemotherapy in stage I UPSC and CCC of the endometrium. Further large study with analysis stratified by MI or LVSI is required.

KEYWORDS:

Adenocarcinoma, Clear Cell; Adenocarcinoma, Papillary; Chemotherapy, Adjuvant; Endometrial Neoplasms; Radiotherapy, Adjuvant

PMID:
30887761
PMCID:
PMC6424839
[Available on 2019-05-01]
DOI:
10.3802/jgo.2019.30.e44
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