Introduction/Background The most common cause of death due to endometrial cancer depends on the high risk histologies as we call type 2 cancer. There is no definite recommendation for early stage disease in the international guidelines. We aimed to investigate different adjuvant modalities in high grade endometrioid and non-endometrioid FIGO stage 1 and 2 patients.
Methodology Retrospective database review was performed to identify endometrial cancer patients which were surgically staged between 2006 and 2016 in Istanbul Faculty of Medicine. Patients were compared regarding their clinical, demographical, surgical and pathological differences using independent two test and chi-square test. Kaplan-Meier method was used to calculate disease progression free survival and overall survival in women with type 2 endometrium cancer followed with two different treatment modalities postoperatively.
Results A total of 124 patients were included. Mean age and body mass index (BMI) were 63.1 years and 31.8 kg/m2. Thirty-eight (30.6%) patients were grade 3 endometrioid, twenty-seven (21.8%) patients were serous type endometrial cancer. Pelvic lymphadenectomy were done for all patients and mean lymph node was 13.3. Adjuvant treatments were brachytherapy (12.9%), pelvic radiotherapy (27.4%), chemotherapy+brachytherapy (22.6%), chemotherapy+pelvic radiotherapy (22.6%) and chemotherapy alone (14.5%). Patients were divided into two groups as chemotherapy and radiotherapy. Age, BMI, pelvic and para-aortic lymph node numbers, presence of lympho-vascular space invasion were not statistically significant different between groups. High grade endometrioid cancer and stage 1b disease were statistically significantly higher in radiotherapy group (p<0.001). In the Kaplan-Meier analysis chemotherapy group had better progression-free survival (log rank p=0.031). But overall-survival was similar between groups (log rank p=0.532).
Conclusion Chemotherapy seems to be a better option for early stage type 2 endometrial cancer.
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