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Adjuvant Radiation Therapy for Patients With Type II Endometrial Carcinoma: Impact on Tumor Recurrence and Survival
  1. Raphael Yechieli, MD*,
  2. Nabila Rasool, MD,
  3. Jared R. Robbins, MD*,
  4. Chad M. Cogan, MS and
  5. Mohamed A. Elshaikh, MD*
  1. *Department of Radiation Oncology,
  2. Division of Gynecologic Oncology, Department of Women’s Health Services, and
  3. Department of Public Health Science, Henry Ford Hospital, Detroit, MI.
  1. Address correspondence and reprint requests to Mohamed A. Elshaikh, MD, Department of Radiation Oncology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202. E-mail:


Purpose/Objective The optimal adjuvant treatment of type II endometrial carcinoma after hysterectomy remains controversial. The objective of this study was to determine the effect of adjuvant radiation therapy (RT) on recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival in patients with early-stage type II endometrial carcinoma.

Materials and Methods In this institutional review board–approved study, our database of 1450 patients with endometrial cancer was reviewed. Seventy-nine surgically staged patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stages I and II serous and clear cell carcinoma were treated from 1991 to 2010. These patients were then divided into 2 groups; one group received adjuvant RT, and the other group included patients who did not receive adjuvant RT.

Results The median age of the study cohort is 65 years, and the median follow-up is 47 months. Thirty-nine patients (49%) received adjuvant RT, and 40 patients did not. The 5-year RFS was significantly improved in patients who received RT (84% vs 58%; P = 0.002). Similarly, 5-year DSS was significantly improved in patients who received RT (87% vs 58%; P = 0.023) with a trend toward improved 5-year overall survival (74% vs 58%; P = 0.088). On multivariate analysis, lack of angiolymphatic invasion (P < 0.001 and P < 0.001), adjuvant RT (P < 0.001 and P = 0.004), and lack of lower uterine segment involvement (P = 0.007 and P = 0.009) were independent predictors of improved RFS and DSS, respectively.

Conclusions In the current study of surgically staged patients with type II endometrial carcinoma International Federation of Gynecology and Obstetrics stages I and II, adjuvant radiation therapy with or without chemotherapy resulted in a significant improvement in recurrence-free and disease-specific survival.

  • Endometrial carcinoma
  • Uterine serous
  • Clear cell
  • Type II
  • Radiation treatment
  • Chemotherapy

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  • Presented at the Society of Gynecologic Oncology’s 43nd annual meeting on Women’s Cancer, Austin, TX, March 2012.

  • The authors declare no conflicts of interest.