scholarly journals Adjuvant Radiotherapy Approach in Stage I High Risk and High-intermediate Risk Endometrioid-type Uterine Cancers TROD 04-005 Gynecological Tumors Subgroup Survey Study

2021 ◽  
Author(s):  
zeliha güzelöz
Keyword(s):  
High Risk ◽  
Adjuvant Radiotherapy ◽  
Stage I ◽  
Survey Study ◽  
Intermediate Risk ◽  
Gynecological Tumors ◽  
Uterine Cancers

scholarly journals EP-1489 How effective is adjuvant radiotherapy in the management of stage I high-risk endometrial cancer?

2019 ◽  
Vol 133 ◽  
pp. S807
Author(s):  
J. Song ◽  
T. Le ◽  
M. Gaudet ◽  
C. Ee ◽  
K. Lupe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Radiotherapy ◽  
Stage I

scholarly journals A comparison of disease recurrence between robotic versus laparotomy approach in patients with intermediate-risk endometrial cancer

2019 ◽  
Vol 30 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Jiheon Song ◽  
Tien Le ◽  
Laura Hopkins ◽  
Michael Fung-Kee-Fung ◽  
Krystine Lupe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Robotic Surgery ◽  
Cancer Patients ◽  
Adjuvant Radiotherapy ◽  
Combined Treatment ◽  
Stage I ◽  
Oncologic Outcomes ◽  
Intermediate Risk ◽  
Surgery Group ◽  
Laparotomy Group

ObjectiveAdvances in minimally invasive surgery, particularly with robotic surgery, have resulted in improved peri-operative outcomes in patients with endometrial cancer. In addition, randomized trials have shown that addition of adjuvant radiotherapy following surgery improves loco-regional disease control among stage I intermediate-risk endometrial cancer patients. We aimed to investigate the efficacy and safety of combined treatment of robotic surgery and adjuvant radiotherapy in this patient population.MethodsA single-center retrospective study was conducted on stage I endometrioid-type endometrial cancer patients with intermediate-risk features (<50% myometrial involvement and grade 2–3 histopathology, or >50% myometrial involvement and grade 1–2 histopathology) treated with hysterectomy and adjuvant radiotherapy between January 2010 and December 2015. Data on surgery and radiotherapy were collected and correlated with clinical and surgical outcomes using log-rank. Oncologic outcomes were then compared between robotic surgery and laparotomy.ResultsA total of 179 intermediate-risk endometrial cancer patients were identified, of whom 135 (75.4%) received adjuvant radiotherapy and were included in the final analysis. Median age at diagnosis was 63 years (range 40–89) and median follow-up was 4.7 years (range 1.1–8.8). Seventy-seven patients (57%) underwent robotic surgery and 58 patients (43%) underwent laparotomy. Surgical staging with lymph node dissection was performed on 79.3% of the patients. The majority of patients (79.3%) received vaginal brachytherapy as part of adjuvant radiotherapy, while 20.7% received external-beam radiotherapy. Among the entire cohort, eight (5.9%) patients recurred and all eight recurrences occurred in the robotic surgery group; no recurrence was found in the laparotomy group. This translated into 5 year disease-free survival of 100% in the laparotomy group, compared with 91.8% in the robotic surgery group (p=0.005). No difference in overall survival was found between the two groups (p=0.51).ConclusionOncologic outcomes for stage I intermediate-risk endometrial cancer treated with hysterectomy and adjuvant radiotherapy at our institution are comparable to the previously published literature. The higher recurrence rate observed with robotic surgery at our institution has not been observed previously and requires further investigation.

scholarly journals 117 How Effective is Adjuvant Radiotherapy in the Management of Stage I High-Risk Endometrial Cancer?

2019 ◽  
Vol 139 ◽  
pp. S51
Author(s):  
Jiheon Song ◽  
Tien Le ◽  
Marc Gaudet ◽  
E. Choan ◽  
Krystine Lupe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Radiotherapy ◽  
Stage I

scholarly journals Is Adjuvant Radiotherapy Effective in Intermediate-risk Surgical Stage I Endometrial Cancer?

2004 ◽  
Vol 43 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Hung-Chuan Yu ◽  
Chi-Mou Juang ◽  
Ching-Ying Huang ◽  
Nae-Fang Twu ◽  
Ming-Shyen Yen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Stage I ◽  
Intermediate Risk

Patterns of practice and outcomes in intermediate- and high-risk stage I and II endometrial cancer: a population-based study

2007 ◽  
Vol 17 (2) ◽  
pp. 433-440 ◽  
Author(s):  
J. S. Kwon ◽  
M. S. Carey ◽  
E. F. Cook ◽  
F. Qiu ◽  
L. Paszat
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Risk Group ◽  
Population Based ◽  
Stage I ◽  
Surgical Staging ◽  
Intermediate Risk ◽  
Population Based Study ◽  
Grade 3 ◽  
Patterns Of Practice

To evaluate patterns of practice and outcomes in intermediate- and high-risk stage I and II endometrial cancer in the province of Ontario, Canada. This was a retrospective population-based study of women diagnosed with stage I and II endometrial cancer in Ontario from 1996 to 2000. After excluding low-risk (stages IA and IB, grades 1 and 2) and nonendometrioid histologies, the population was stratified into two risk groups: intermediate risk (stages IA and IB, grade 3; stages IC and IIA, grades 1 and 2; stage IIA, grade 3 if <50% myometrial invasion) and high risk (stage IC, grade 3; stage IIA, grade 3 if >50% myometrial invasion, and all stage IIB). Patterns of practice were assessed in each risk group, including use of surgical staging and adjuvant pelvic radiotherapy (APRT). Cox proportional hazards models determined effects of prognostic factors on 5-year overall survival (OS), including age, income, comorbidities, lymphvascular space invasion (LVSI), surgical staging, and APRT. There were 995 women in this study: 748 intermediate risk (75.2%) and 247 high risk (24.8%). Only 69 (9.2%) and 40 (16.2%) women underwent surgical staging in the intermediate- and high-risk groups, respectively. Surgical staging did not reduce rates of APRT. Determinants of survival included age >60 and comorbidities in the intermediate-risk group, and age >60, income, and LVSI in the high-risk group. In this population-based study, there were variable patterns of practice for intermediate- and high-risk stage I and II endometrial cancer. Surgical staging and APRT did not affect OS

Adjuvant radiotherapy use in a population-based sample of breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 617-617
Author(s):  
R. Jagsi ◽  
P. Abrahamse ◽  
J. J. Griggs ◽  
S. J. Katz
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Tumor Size ◽  
Adjuvant Radiotherapy ◽  
Breast Conservation ◽  
Recurrence Risk ◽  
Invasive Disease ◽  
Low Risk ◽  
Socioeconomic Disparities ◽  
Intermediate Risk

617 Background: Previous studies have suggested underutilization and socioeconomic disparities in use of adjuvant radiotherapy (RT) among patients with breast cancer. However, these studies used registry data which may be incomplete. Methods: We evaluated data from 2260 survey respondents with nonmetastatic breast cancer, aged 20–79 years, diagnosed from June 2005-February 2007 in Detroit and Los Angeles and reported to SEER registries (72% response rate). Survey responses regarding treatment and sociodemographic factors were merged to SEER data. Rates of RT receipt were based on patient report. Patients were divided into 3 populations: DCIS pts undergoing breast conservation (BCS), invasive pts undergoing BCS, and invasive pts undergoing mastectomy. These were then stratified based on recurrence risk in the absence of RT (3 groups based on tumor size and grade for DCIS pts, 2 groups separating pts over 70 with Stage I, ER+ tumors from others undergoing BCS for invasive disease, and 3 groups based on tumor size and nodal status for those undergoing mastectomy for invasive disease). Results: Among 306 pts undergoing BCS for DCIS, 85.6% received RT (77.9% of pts at low recurrence risk, 84.8% at intermediate risk, and 95.8% at high risk). Among 1018 pts undergoing BCS for invasive disease, 93.6% received RT (83.6% of low-risk patients and 94.9% of others). Among 661 pts undergoing mastectomy for invasive disease, 39.3% received RT (81.5% of pts at high-risk, 44.5% at intermediate-risk, and 12.1% at low risk). In separate multivariate logistic regression models including risk grouping and sociodemographic variables for each population, there were no significant associations between RT receipt and race, education, or income. Among pts receiving RT, delay was reported by 15.9% of the DCIS group, 19.5% of those treated for invasive disease after BCS, and 27.4% of those treated for invasive disease after mastectomy. Conclusions: RT use is high after BCS with little evidence of socioeconomic disparities. But lower than optimal rates after mastectomy even among patients with high expected benefit suggest lingering barriers to effective treatment in these patients. Less RT use in patients with lower expected benefit suggests that legitimate clinical uncertainty influences decision-making. No significant financial relationships to disclose.

scholarly journals (P046) Factors Predictive of Receiving Adjuvant Radiotherapy in High-Intermediate Risk Stage I Endometrial Cancer

2017 ◽  
Vol 98 (2) ◽  
pp. E27
Author(s):  
Ariel Pollock ◽  
Mary McGunigal ◽  
John T. Doucette ◽  
Jerry Liu ◽  
Manjeet Chadha ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Stage I ◽  
Intermediate Risk

Prognostic Factors for Survival After 2-CdA-Based Therapy for Symptomatic Waldenström Macroglobulinemia (WM) Stratify Patients Into Low- and High-Risk Groups.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1668-1668
Author(s):  
Sheeba K Thomas ◽  
Lei Feng ◽  
Kay B Delasalle ◽  
Michael Wang ◽  
Jatin J Shah ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Retrospective Studies ◽  
Risk Group ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Primary Therapy ◽  
Intermediate Risk

Abstract Abstract 1668 Poster Board I-694 Introduction Retrospective studies performed by others between 2001-2009, have identified various prognostic factors for survival among patients with symptomatic WM. These include hemoglobin, platelet count, albumin, and β2-micrglobulin (β2M) at varied cutoffs, as well as gender, age, IgM level, monoclonal (M) protein level, hyperviscosity syndrome, prior therapy, presence of splenomegaly/organomegaly, stage as defined by the International Staging System for multiple myeloma (ISSMM) and risk score as defined by the International prognostic scoring system for Waldenström macroglobulinemia (IPSSWM). Methods We retrospectively analyzed our experience with 80 previously untreated patients with symptomatic WM who participated on one of four 2-chlorodeoxyadenosine (2-CdA)-based clinical trials between 3/90-5/02, to identify factors predicting overall survival. Patients received either 2 consecutive 4-6 week courses of 2-CdA at 1.5 mg/m2 subcutaneously three times daily for 7 days (d) alone (10 patients), with prednisone (Pred) at 60 mg/m2 orally (po) d1-7 (21 patients), with cyclophosphamide (Cy) at 40 mg/m2 po twice daily (bid) for 7d (31 patients), or with Cy at 40 mg/m2 po bid for 7d + rituximab (Rit) at 375 mg/m2 intravenously weekly for 4 weeks (18 patients). Overall survival (OS) from the start of therapy was censored as of April 1, 2009. Predictive factors identified by multivariate analysis in other retrospective studies, as well as other clinically relevant factors, were evaluated. Results Median age of patients was 62.1 years (range 35.9-80.1), and 41 were male. Median hemoglobin was 10 g/dL (5.6-15.6), platelet count was 243 K/μL (26-654), albumin was 4.1 g/dL (2.5-5.4), and β2M was 3.3 mg/L (1.4-15.9). Splenomegaly and lymphadenopathy (≥ 2 cm) were present in 29.1% and 28.8% of patients, respectively. By ISSMM, 38 patients were Stage I, 29 were Stage II, and 13 were Stage III. By IPSSWM, 24 patients were low-risk, 45 were intermediate-risk, and 11 were high-risk. With a median follow-up of 9.9 years (yrs; range 0.9-16.8), median OS for all patients was 8.9yrs (0.1 yrs-not reached (NR)). By univariate analysis, age <65y, primary therapy (2CdA/Cy/Rit >2CdA/Cy > 2CdA >2CdA/Pred), albumin ≥3.5 g/dL, B2M <3.5 mg/L vs. 3.5-5.5 mg/L vs. >5.5 mg/L, ISSMM and IPSSWM, were all significant (p< 0.05). In multi-covariate models, primary therapy (2CdA/Cy/Rit vs. other 2CdA regimens), age, ISSMM, and IPSSWM remained significant. Removing the 2CdA/Pred cohort (which had the poorest OS) from the analysis of primary therapy, the trend toward superior OS with 2CdA/Cy/Rit vs. 2CdA+2CdA/Cy persisted (NR vs. 9.2 yrs), but did not reach statistical significance (p=0.12). Median OS for patients of age <65 yrs was 15.4 yrs compared with 6.2 yrs for those age ≥65 yrs (p=0.03). ISSMM stage I disease was associated with a median OS of 12.5 yrs, while stage II was 6.3 yrs, and stage III was 6.0 yrs (p=0.02). By comparison, median OS has not yet been reached among those classified as having low-risk disease by IPSSWM, while the intermediate-risk group has a median OS of 6.5 yrs, and the high-risk group has a median OS of 5.8 yrs (p=0.03). Conclusion Both ISSMM and IPSSWM are predictive of overall survival among patients with symptomatic WM treated first-line with 2CdA-based regimens. In our experience, rates of 10 year OS were better stratified by age, <65 yrs (62%) vs. ≥65 yrs (30%), and IPSSWM risk score, low (63%) vs. intermediate (46%) vs. high (24%), than by ISSMM stage (stage I [58%] vs. stage II [49%] vs. stage III [0%]). Novel therapeutic strategies are needed to improve the survival of patients with WM who are of older age, or who have high-risk IPSSWM or higher stage ISSMM disease. Longer follow-up is needed to confirm the trend toward improved survival seen with the addition of rituximab to 2CdA-based therapy. Disclosures No relevant conflicts of interest to declare.

Pathological Stage I Endometrial Carcinoma: The Role for Adjuvant Radiotherapy

1993 ◽  
Vol 79 (6) ◽  
pp. 405-409 ◽  
Author(s):  
Massad Barhum ◽  
Moshe Stein ◽  
Eduardo Ronsenblatt ◽  
Janet Dale ◽  
Abraham Kuten
Keyword(s):  
Radiation Therapy ◽  
High Risk ◽  
Endometrial Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Stage I ◽  
Pathological Stage ◽  
Postoperative Radiation Therapy

Background In order to assess the efficacy of adjuvant radiotherapy in the treatment of pathological stage I endometrial carcinoma, we performed a retrospective analysis of 158 patients with this diagnosis who after surgery were either treated with radiation therapy or only followed from January 1980 through December 1987. Methods Patients were divided into two prognostic categories, high and low risk, on the basis of three known predictors of survival: histology, differentiation, and depth of myometrial invasion. All patients underwent total abdominal hysterectomy and bilateral salpingooophorectomy but only the high risk group received radiotherapy as well. Results After a median follow up time of 59 months the survival rates of the two groups were similar. The 5-year disease-free survival of the surgery alone group was 92 % compared to 89 % for the postoperative radiotherapy group. Side effects of treatment were minimal. Conclusions Postoperative radiation therapy for high risk pathological stage I endometrial carcinoma is an effective adjuvant therapy and confers an excellent prognosis.

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