Skip Navigation LinksHome > December 2010 - Volume 20 - Issue 9 > Postoperative Radiotherapy in Stage I/II Endometrial Cancer:...
International Journal of Gynecological Cancer:
doi: 10.1111/IGC.0b013e3181f8fa26
Ovarian Cancer

Postoperative Radiotherapy in Stage I/II Endometrial Cancer: Retrospective Analysis of 883 Patients Treated at the University of Florence

Scotti, Vieri MD*; Borghesi, Simona MD†; Meattini, Icro MD*; Saieva, Calogero MD‡; Rossi, Francesca MD§; Petrucci, Alessia MD∥; Galardi, Alessandra MD*; Livi, Lorenzo MD*; Agresti, Benedetta MD*; Fambrini, Massimiliano MD¶; Marchionni, Mauro MD¶; Biti, Giampaolo MD*

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Abstract

Introduction: The efficacy of postoperative radiotherapy (RT) in the treatment of early-stage endometrial carcinoma (EC) is still under debate. This study was aimed to review the outcome and adverse effects in patients treated for EC with postoperative RT at a single center.

Methods: A total of 883 patients with pathological stages I to II EC were retrospectively analyzed. Surgery consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy, or vaginal hysteroannessiectomy in 532 patients (60.2%) with pelvic lymphadenectomy in 351 patients (39.8%). Seven hundred forty-seven patients (84.6%) underwent whole pelvic RT (WPRT) and 136 (15.4%) combined WPRT and vaginal brachytherapy (BT) boost.

Results: At a median follow-up of 9 years (range, 1.2-27.6 years), we observed 10.6% disease relapse. Forty-seven patients experienced local recurrence (LR), and 38 patients experienced distant metastases (DMs). At univariate analysis, age at diagnosis (P < 0.0001), stage (P < 0.04), and histological subtype (P < 0.0001) resulted in significant prognostic factors. At multivariate analysis, histotype emerged as an independent relapse predictor (P = 0.0001). Acute WPRT-related toxicity was mild; diarrhea was the most common adverse effect (19.8%). We recorded long-term adverse effects in 7.8% of the patients.

Conclusions: Our study showed that patients with early-stage EC have a good outcome in overall survival and disease-free survival. In our experience, standard surgery (including hysterectomy and bilateral salpingo-oophorectomy followed by WPRT with or without BT) showed an acceptable toxicity profile.

Copyright © 2010 by IGCS and ESGO

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