The role of adjuvant chemotherapy in FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma treated with surgery and postoperative radiotherapy

2021 ◽  
Vol 162 ◽  
pp. S303-S304
Author(s):  
Leonid Reshko ◽  
Jeremy Gaskins ◽  
Sara Dryden ◽  
Daniel Metzinger ◽  
Sarah Todd ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Postoperative Radiotherapy ◽  
Figo Stage ◽  
Endometrioid Adenocarcinoma ◽  
Stage Ib ◽  
Grade 3 ◽  
Endometrial Endometrioid Adenocarcinoma

Role of adjuvant chemotherapy in patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma treated with surgery and post-operative radiotherapy

2021 ◽  
pp. ijgc-2021-002380
Author(s):  
Leonid B Reshko ◽  
Jeremy T Gaskins ◽  
Sara M Dryden ◽  
Daniel S Metzinger ◽  
Sarah L Todd ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Radiotherapy ◽  
Cox Model ◽  
Figo Stage ◽  
Endometrioid Adenocarcinoma ◽  
Stage Ib ◽  
Grade 3 ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Lymphovascular Space Invasion

BackgroundThe optimal treatment of patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma remains unknown.ObjectiveTo compare overall survival following treatment with a hysterectomy and adjuvant radiotherapy with or without chemotherapy in this group of patients.MethodsPatients diagnosed between January 2004 and January 2016 with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma treated with hysterectomy and postoperative radiotherapy with or without adjuvant concurrent chemotherapy were identified in the National Cancer Database. Overall survival was assessed with Kaplan-Meier curves. A Cox model was constructed to evaluate survival after controlling for confounding variables. A logistic regression model was used to reveal predictors of chemotherapy use.ResultsA total of 2173 patients were included. The receipt of chemotherapy was associated with an increased 5-year overall survival from 67.6% to 75.6% (p=0.0313). This association trended toward statistical significance on multivariate analysis (adjusted HR (aHR) 0.80; 95% CI 0.63 to 1.01; p=0.0653). Other factors associated with improved survival were undergoing a lymphadenectomy, absence of lymphovascular space invasion, younger age, smaller tumor size, non-black race, and absence of comorbidities. Patients who underwent brachytherapy, had lymphovascular space invasion, were younger, were diagnosed in the more recent years, and were treated in higher volume centers were more likely to receive adjuvant chemotherapy.ConclusionAdjuvant chemotherapy and radiation therapy were associated with an increase in survival in patients with FIGO stage IB grade 3 endometrial endometrioid adenocarcinoma compared with those treated with adjuvant radiotherapy alone.

scholarly journals Clinical Practice of Adjuvant Chemotherapy in Patients with Early-Stage Epithelial Ovarian Cancer

Chemotherapy ◽  
2016 ◽  
Vol 61 (6) ◽  
pp. 287-294
Author(s):  
Lindy M.J. Frielink ◽  
Brenda M. Pijlman ◽  
Nicole P.M. Ezendam ◽  
Johanna M.A. Pijnenborg
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Figo Stage ◽  
Selective Treatment ◽  
Platinum Based Chemotherapy ◽  
Grade 3 ◽  
Practice Methods

Background: Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. Methods: All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The percentage of patients that received adjuvant chemotherapy was determined as well as the comprehensiveness of staging and outcome. Results: Forty percent (54/135) of the patients with early-stage EOC received adjuvant chemotherapy. Treatment with adjuvant chemotherapy was associated with FIGO stage, clear-cell histology and nonoptimal staging. Optimal staging was achieved in 50%, and nonoptimal staging was associated with advanced age, comorbidity and treatment in a non-referral hospital. Overall, there was no difference in outcome between patients with and without adjuvant chemotherapy. Yet, in grade 3 tumors, adjuvant chemotherapy seems beneficial. Conclusions: Selective treatment of patients with early-stage EOC might reduce adjuvant chemotherapy without compromising outcome.

Outcome of High-Risk Stage IC, Grade 3, Compared With Stage I Endometrial Carcinoma Patients: The Postoperative Radiation Therapy in Endometrial Carcinoma Trial

2004 ◽  
Vol 22 (7) ◽  
pp. 1234-1241 ◽  
Author(s):  
Carien L. Creutzberg ◽  
Wim L.J. van Putten ◽  
Carla C. Wárlám-Rodenhuis ◽  
Alfons C.M. van den Bergh ◽  
Karin A.J. De Winter ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
High Risk ◽  
Endometrial Carcinoma ◽  
Postoperative Radiotherapy ◽  
Risk Category ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Stage Ib ◽  
Grade 3

Purpose Stage IC, grade 3 endometrial cancer is regarded as a high-risk category. Stage IC, grade 3 patients were not eligible for the randomized Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial, but were registered and received postoperative radiotherapy. Patients and Methods The PORTEC trial included 715 patients with stage IC, grade 1 or 2, and stage IB, grade 2 or 3 endometrial cancer. Patients were randomly assigned after surgery to receive pelvic radiotherapy (RT) or no further treatment. A total of 104 patients with stage IC, grade 3 endometrial cancer were registered, of whom 99 could be evaluated. Patterns of relapse and survival were compared with PORTEC patients receiving RT. Median follow-up was 83 months. Results The actuarial 5-year rates of locoregional relapse were 1% to 3% for PORTEC patients who received RT, compared with 14% for stage IC, grade 3 patients. Five-year distant metastases rates were 3% to 8% for grade 1 and 2 tumors; 20% for stage IB, grade 3 tumors; and 31% for stage IC, grade 3 tumors. Overall survival rates were 83% to 85% for grades 1 and 2; 74% for stage IB, grade 3; and 58% for stage IC, grade 3 patients (P < .001). In multivariate analysis grade 3 was the most important adverse prognostic factor for relapse and death as a result of endometrial cancer (hazard ratios, 5.4 and 5.5; P < .0001). Conclusion Patients with stage IC, grade 3 endometrial carcinoma are at high risk of early distant spread and endometrial carcinoma-related death. Novel strategies for adjuvant therapy should be explored to improve survival for this patient group.

scholarly journals The Role of Intravaginal Brachytherapy in Surgically-Staged 1988 Figo Stage IC Grade 3 Endometrial Cancer

2012 ◽  
Vol 23 ◽  
pp. ix329
Author(s):  
B. Barney ◽  
I.A. Petersen ◽  
J.A. Call ◽  
A. Grothey ◽  
M.G. Haddock
Keyword(s):  
Endometrial Cancer ◽  
Figo Stage ◽  
Grade 3

Refining the role of adjuvant chemotherapy in stage IB and IIA NSCLC.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8519-8519
Author(s):  
Ranjan Pathak ◽  
Jessica R Hoag ◽  
Sarah B. Goldberg ◽  
Andres F Monsalve ◽  
Benjamin Resio ◽  
...  
Keyword(s):  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Proportional Hazards ◽  
Single Agent ◽  
Cox Proportional Hazards ◽  
R0 Resection ◽  
Cancer Data ◽  
Stage Ib ◽  
Immortal Time Bias

8519 Background: The role of adjuvant chemotherapy (AC) in stage IB (pT2aN0) and IIA (pT2bN0) non-small cell lung cancer (NSCLC) is currently unclear. Existing guideline recommendations are inconsistent, ranging from all tumors >4 cm, to any patient with “high-risk features” (visceral pleural invasion (VPI), lymphovascular invasion (LVI), high grade, or sublobar resection). We used the National Cancer Data Base (NCDB) to clarify the role of AC in pT2N0 patients. Methods: The NCDB was queried for treatment-naïve, post-R0 resection, pT2N0 (AJCC 8th edition) NSCLC patients between 2010 & 2014. Patients treated with single-agent AC were excluded. Survival was calculated from 30 days after surgery to minimize immortal time bias. Multivariable Cox proportional hazards regression was used to estimate the association between AC and survival across tumor sizes (T2a: 3-4 cm and T2b: 4-5 cm to reflect guideline stratifications) and risk features. Results: Of the 10,127 patients identified, 1,856 (18%) received multi-agent AC. AC patients tended to be younger (median age 64 vs 70 yrs, p<0.001), privately insured (40% vs 24%, p<0.001), treated at a non-academic center (71% vs 66%, p<0.001), and comorbidities-free (53% vs 48%, p<0.001). In T2a patients (N=6,699), AC was not significantly associated with a mortality reduction, regardless of the presence of any high-risk features. In T2b patients (N=3,428), AC (N=931, 27%) was associated with a lower mortality (HR 0.77, 95% CI 0.65-0.9, p=0.001). However, in the absence of any high-risk features (N=1414, 41% of the 4-5 cm cohort), AC was not significantly associated with survival benefit (Table). Conclusions: The presence of high-risk features does not appear to support the guideline recommendations regarding the use of AC in stage IB patients with 3-4 cm tumors. On the other hand, the benefit of AC for 4-5 cm tumors may be limited to patients with at least one high-risk feature. [Table: see text]

Role of adjuvant chemotherapy for patients with FIGO stage I high-intermediate risk endometrial carcinoma with lymph-vascular invasion

2021 ◽  
Vol 162 ◽  
pp. S267-S268 ◽  
Author(s):  
Dimitrios Nasioudis ◽  
Erin McMinn ◽  
Emily Ko ◽  
Ashley Haggerty ◽  
Lori Cory ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Endometrial Carcinoma ◽  
Vascular Invasion ◽  
Figo Stage ◽  
Stage I ◽  
Intermediate Risk

scholarly journals Concurrent Malignant Solitary Fibrous Tumor Arising from the Omentum and Grade 3 Endometrial Endometrioid Adenocarcinoma of the Uterus withp53Immunoreactivity

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Naoya Harada ◽  
Ichiro Nobuhara ◽  
Noriko Haruta ◽  
Yumi Higashiura ◽  
Hideki Watanabe ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Vaginal Discharge ◽  
Endometrioid Adenocarcinoma ◽  
Resonance Imaging ◽  
Uterine Corpus ◽  
First Case ◽  
Grade 3 ◽  
Fibrous Tumor ◽  
Endometrial Endometrioid Adenocarcinoma ◽  
Secondary Malignant Tumor

A malignant solitary fibrous tumor arising from the omentum is extremely rare. To our knowledge, this is the first case of a malignant solitary fibrous omentum tumor coexisting with uterine corpus cancer. A 62-year-old woman presented to our hospital with vaginal discharge. Endometrioid adenocarcinoma was diagnosed by endometrial curettage. In addition, a solid tumor in front of the uterus was detected following computed tomography and/or magnetic resonance imaging, which was suspected to be a primary (or secondary) malignant tumor arising from the omentum. Hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy were performed. A malignant solitary fibrous tumor of the omentum and grade 3 endometrioid adenocarcinoma of the uterus were diagnosed by pathohistological analysis. Interestingly, the tumor cells were immunoreactive forp53. Adjuvant chemotherapy was administered for the uterine corpus cancer and the patient remains healthy 48 months after the surgery. These tumors may have become malignant due to the presence ofp53mutations.

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