Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma

2016 ◽  
Vol 56 (2) ◽  
pp. 199-206 ◽  
Author(s):  
Hamdullah Sozen ◽  
Rumeysa Çiftçi ◽  
Dogan Vatansever ◽  
Samet Topuz ◽  
Ahmet Cem Iyibozkurt ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Type Ii

The Role of Adjuvant Chemotherapy in Surgical Stages I-II Serous and Clear Cell Carcinomas and Carcinosarcoma of the Endometrium: A Collaborative Study

2011 ◽  
Vol 21 (2) ◽  
pp. 332-336 ◽  
Author(s):  
Ingrid Vandenput ◽  
Jone Trovik ◽  
Ignace Vergote ◽  
Philippe Moerman ◽  
Karin Leunen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Clear Cell ◽  
Early Stage ◽  
Surgical Staging ◽  
Recurrence Free Survival ◽  
Type Ii ◽  
Free Survival ◽  
Group A ◽  
Group B

Objective:To assess the impact of adjuvant chemotherapy in early surgically staged type II endometrial cancer (serous [S], clear cell carcinoma [CC]) and carcinosarcomas (CS) on recurrence and survival.Materials and Methods:Patients diagnosed with stages I-II S-CC and CS after comprehensive surgical staging were retrospectively collected. Surgical staging was defined as pelvic lymphadenectomy of more than 11 nodes harvested and exploration of the upper abdomen, with our without omentectomy. Groups with (group A) and without (group B) platinum-based chemotherapy were compared.Results:We identified 69 patients with a mean age of 66 years (range, 48-88 years). Both groups showed similar baseline characteristics. Group A consisted of 34 patients (23 S-CC, 11 CS) with 10 (29%) recurrences outside the pelvis (7 S-CC, 3 CS). Group B included 35 patients (28 S-CC, 7 CS) of which 10 (29%) developed recurrence outside the pelvis (7 S-CC, 3 CS). The median recurrence-free survival was 22 months (range, 13-51 months) for group A versus 10 months (range, 1-59 months) for group B (P= 0.437). Five patients (15%) of group A and 9 (26%) of group B died of disease after a median follow-up of 29 months (range, 20-59 months) and 17 months (range, 4-64 months), respectively (P= 0.168).Conclusion:Recurrences in early-stage type II endometrial cancer and carcinosarcomas occur irrespective of adjuvant chemotherapy, but recurrence-free survival is prolonged when adjuvant chemotherapy is administered. Only prospective randomized intergroup trials can address the benefit of adjuvant chemotherapy in early-stage high-risk endometrial cancer.

scholarly journals Controversies in the Treatment of Early Stage Endometrial Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Joshua Z. Press ◽  
Walter H. Gotlieb
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Sentinel Lymph Node Mapping ◽  
Optimal Management ◽  
Lymph Node Mapping ◽  
Randomized Controlled ◽  
Extent Of Surgery ◽  
Early Stage Endometrial Cancer

Despite the publication of numerous studies, including some multicentered randomized controlled trials, there continues to be vigorous debate regarding the optimal management of early stage endometrial cancer, including the extent of surgery and the role of adjuvant chemotherapy and radiation. Resolving these questions has become increasingly important in view of the increase of endometrial cancer, related to the aging population and the alarming incidence of obesity. Furthermore, there are more surgical challenges encountered when operating on elderly patients or on patients with increased BMI and the associated comorbidities, such as diabetes, hypertension, heart disease, and pulmonary dysfunction. This paper will focus on the advantages of minimally invasive surgery, the value of lymphadenectomy including sentinel lymph node mapping, and some of the current controversies surrounding adjuvant chemotherapy and radiation.

The Addition of Adjuvant Chemotherapy to Radiation in Early-Stage High-Risk Endometrial Cancer

2017 ◽  
Vol 27 (5) ◽  
pp. 912-922 ◽  
Author(s):  
Dustin Boothe ◽  
Ned Williams ◽  
Bismarck Odei ◽  
Matthew M. Poppe ◽  
Theresa L. Werner ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Early Stage

scholarly journals The Survival Effect of Ovary Preservation in Early Stage Endometrial Cancer: A Single Institution Retrospective Analysis

2020 ◽  
Author(s):  
Wonkyo Shin ◽  
Sang-Yoon Park ◽  
Sokbom Kang ◽  
Myong Cheol Lim ◽  
Sang-Soo Seo
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Early Stage ◽  
Figo Stage ◽  
Factors Affecting ◽  
Chemotherapy Administration ◽  
Survival Effect ◽  
Removal Group ◽  
Early Stage Endometrial Cancer

Abstract Purpose: We investigated the effect of ovary preserving surgery in early International Federation of Obstetrics and Gynecology (FIGO) stage endometrial cancer patients.Methods: Medical records were retrospectively reviewed for 539 patients who were diagnosed with early stage endometrial cancer between Jan 2006 and Dec 2017. Patients were categorized into ovary preservation and ovary removal groups. Demographics, recurrence free survival (RFS), and five-year overall survival (OS) rate were compared, and the clinical factors affecting survival were evaluated by univariate and multivariate analysis.Results: The median follow-up period was 85 months (range, 6-142 months), and the median age was 52.7 years. The mean age was higher in the ovary removal group than in the ovary preservation group (54.4 vs 40.94 years; P < 0.001). The ovary preservation group showed an earlier FIGO stage than the ovary removal group. (P = 0.0264). There was a greater incidence of adjuvant chemotherapy administration in the removal group. There were no statistical differences in other baseline characteristics.When comparing the RFS and OS rates, there were no statistical differences between the preservation and removal groups. (recurrence free rate 98.5% vs 92.7%, p = 0.4360, and 5-year survival rate 98.6% vs 93.0%, p = 0.0892, respectively). Endometrioid histology (p=0.006) and post-operative adjuvant chemotherapy (p=0.0062) were related to OS, and adjuvant chemotherapy (p<0.001) and radiotherapy (p=0.005) were related to RFSConclusions: Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients

scholarly journals Prognosis and adjuvant chemotherapy for patients with positive peritoneal cytology in stage IA endometrial cancer

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Motoko Kanno ◽  
Mayu Yunokawa ◽  
Makoto Nakabayashi ◽  
Makiko Omi ◽  
Ai Ikki ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Peritoneal Cytology ◽  
Type Ii ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Stage Ia ◽  
Positive Peritoneal Cytology ◽  
Risk Factors For Recurrence

AbstractThis study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. We retrospectively analyzed the data of patients with stage IA endometrial cancer admitted in our hospital between 2005 and 2015. Among 989 patients who underwent peritoneal cytology, 135 (13.7%) had PPC. Multivariate analysis extracted several independent risk factors for recurrence in stage IA patients, including those with PPC. Adjuvant chemotherapy did not cause a significant difference in the 5-year relapse-free survival rate in patients with PPC (p = 0.78). Similarly, the 5-year recurrence-free survival rate with or without chemotherapy was not different among type II cancer patients (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in patients with PPC and type II was very low (66.7%). While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. While it is controversial whether adjuvant chemotherapy should be administered in stage IA uterine cancer with only PPC as a prognostic factor, it should be considered for early-stage patients who have multiple risk factors for recurrence.

Adjuvant chemotherapy in early-stage endometrioid endometrial cancer with >50% myometrial invasion and negative lymph nodes

2021 ◽  
Vol 31 (4) ◽  
pp. 537-544
Author(s):  
Francesco Multinu ◽  
Simone Garzon ◽  
Amy L Weaver ◽  
Michaela E. McGree ◽  
Enrico Sartori ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Endometrioid Endometrial Cancer ◽  
Negative Lymph Nodes

ObjectiveThe role of adjuvant chemotherapy as an addition or alternative to radiotherapy for early-stage high-risk endometrioid endometrial cancer is controversial. This study aimed to investigate the role of adjuvant chemotherapy in early-stage high-risk endometrioid endometrial cancer.MethodsWe identified patients with stage I or II endometrioid grade 2 or 3 endometrial cancer with myometrial invasion >50% and negative lymph nodes after pelvic with or without para-aortic lymphadenectomy at four institutions (USA and Italy). Associations between chemotherapy and cause-specific and recurrence-free survival were assessed with Cox proportional hazards models. Hematogenous, peritoneal, and lymphatic recurrences were defined as 'non-vaginal'.ResultsWe identified 329 patients of mean (SD) age 66.4 (9.8) years. The median follow-up among those alive was 84 (IQR 44–133) months. The 5-year cause-specific survival was 86.1% (95% CI 82.0% to 90.4%) and the 5-year recurrence-free survival was 82.2% (95% CI 77.9% to 86.8%). Stage II (vs stage IB) was associated with poorer cause-specific and recurrence-free survival. A total of 58 (90.6%) of 64 patients who had chemotherapy had 4–6 cycles of platinum-based regimen. In adjusted analysis, we did not observe a statistically significant improvement in cause-specific survival (HR 0.34; 95% CI 0.11 to 1.03; p=0.06) or non-vaginal recurrence-free survival (HR 0.36; 95% CI 0.12 to 1.08; p=0.07) with adjuvant chemotherapy. Sixteen of 18 lymphatic recurrences (88.9%; 3/5 pelvic, all 13 para-aortic) were observed in the 265 patients who did not receive adjuvant chemotherapy. Among stage II patients, no deaths (100% 5-year recurrence-free survival) were observed in the eight patients who received adjuvant chemotherapy compared with 66% 5-year recurrence-free survival in the 34 patients who did not.ConclusionAlthough we observed that adjuvant chemotherapy was associated with improved oncologic outcomes in early-stage high-risk endometrioid endometrial cancer, the associations did not meet conventional levels of statistical significance. Further research is warranted in this relatively uncommon subgroup of patients.

Minilaparotomy for type II and III radical hysterectomy: technique, feasibility, and complications

2004 ◽  
Vol 14 (5) ◽  
pp. 852-859 ◽  
Author(s):  
A. Fagotti ◽  
F. Fanfani ◽  
A. Ercoli ◽  
L. Patrizi ◽  
S. Mancuso ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Gynecologic Oncology ◽  
Postoperative Outcome ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Type Ii ◽  
Pfannenstiel Incision ◽  
The Mean

The objective was to assess the feasibility, the operative and postoperative outcome, and complications in the use of minilaparotomy for type II and III radical hysterectomy (RH) and pelvic lymphadenectomy (PLN) in early-stage cervical/endometrial cancer. A pilot study on 91 consecutive patients submitted to type II and III RH and PLN for early-stage cervical/endometrial cancer was performed between March 2002 and May 2003 in the Division of Gynecologic Oncology (UCSC, Rome). Thirty-two of 91 cases (35.2%) were eligible for minilaparotomy. The mean operative time was 156.7 min, whereas the mean intraoperative estimate of blood loss was 303.7 ml. A mean number of 32.7 pelvic lymph nodes and 6.2 common iliac nodes were removed. Ileus and removal of bladder catheter were on mean postoperative day 2.4 and 3.4, respectively. The mean number of postoperative days spent in the hospital was 3.7. Intra- and postoperative parameters were compared to laparotomy controls and literature data on laparoscopy and Pfannenstiel incision, showing substantially comparable results. Minilaparotomy is acceptable for selected patients undergoing radical abdominal hysterectomy (RAH) and PLN and does not compromise the adequacy of the procedure. It can be considered as an alternative to the classic midline vertical incision or even to the Pfannenstiel incisions and laparoscopy.

Is body mass index a prognostic factor in patients with early-stage type II endometrial cancer?

2013 ◽  
Vol 130 (1) ◽  
pp. e76-e77
Author(s):  
R. Jalloul ◽  
Z. Al-Wahab ◽  
M. Alshaikh ◽  
T. Buekers ◽  
M. Mahan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Body Mass ◽  
Early Stage ◽  
Type Ii

Outcomes of patients with endometrial cancer and aggressive histology.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16536-e16536
Author(s):  
Samed Rahatli ◽  
Nadire Kucukoztas ◽  
Omer Dizdar ◽  
Polat Dursun ◽  
Selim Yalcin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Total Abdominal Hysterectomy ◽  
Figo Stage ◽  
Abdominal Hysterectomy ◽  
Aggressive Histology ◽  
Patient Series ◽  
Post Menopausal

e16536 Background: To present patterns of practice and outcomes of patients with early stage poor histology endometrial cancer. Methods: Records of the patients with FIGO stage I-II serous papillary, clear cell, mixed or undifferentiated endometrial cancer were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging lymphadenectomy, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant chemotherapy was offered to all patients and given unless the patient refused. Results: 38 patients with early stage poor histology were identified Median age was 61 and 86.8 % of the patients were post menopausal. Median BMI was 31.2 kg/m2. 28 patients (73.7%) received chemotherapy (90% with paclitaxel and carboplatin for 6 cycles). 5 patients (13.2 %) received external radiotherapy 3 patients (7.9%) received brachytherapy. Median follow up was 19 mos. Totally 3 patients (7.9%) had relapse on follow up; Among those who received adjuvant chemotherapy, only one patient had recurrence on vaginal cuff and was treated with radiotherapy and currently disease free for 4 years. Among those who did not receive adjuvant chemotherapy, 2 patients had widespread abdominal and distal recurrence and died on follow up. 2 patients died without recurrence. Conclusions: Complete surgical staging and adjuvant chemotherapy results in excellent prognosis in our patient series. [Table: see text]

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