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EP544 Saten III - splitting adjuvant treatment into subgroups of stage III endometrioid endometrial cancers: an international, multicenter study
  1. I Kahramanoglu1,2,
  2. MM Meydanli3,
  3. S Taranenka4,
  4. A Ayhan5,
  5. C Salman6,
  6. M Sanci7,
  7. F Demirkiran1,
  8. F Ortac8,
  9. D Haidopoulos9,
  10. V Sukhin10,
  11. D Kaidarova11,
  12. A Stepanyan12,
  13. F Farazaneh13,
  14. S Aliyev14,
  15. E Ulrikh15,
  16. D Kurdiani16,
  17. I Yalcin3,
  18. S Mavrichev4,
  19. H Akilli5,
  20. ME Sari3,
  21. A Pletnev4,
  22. K Aslan3,
  23. T Bese1,
  24. M Kairbayev17,
  25. D Vlachos9,
  26. M Gultekin6,
  27. Central Asia and East Europe Trial (CentEAST) Group
  1. 1Department of Gynecologic Oncology, Istanbul University-Cerrahpasa, School of Medicine, Istanbul
  2. 2University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakir
  3. 3Zekai Tahir Burak Women's Health Training and Research Hospital, Ankara, Turkey
  4. 4N.N. Alexandrov Cancer Center of Belarus, Minsk, Belarus
  5. 5Baskent University Faculty of Medicine
  6. 6Hacettepe University, Ankara
  7. 7Tepecik Education and Research Hospital, İzmir
  8. 8Ankara University, Ankara, Turkey
  9. 9University of Athens, Alexandra Hospital, Athens, Greece
  10. 10Grigoriev Institute for Medical Radiology, Kharkiv, Ukraine
  11. 11Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
  12. 12NAIRI Medical Center, Yerevan, Armenia
  13. 13Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
  14. 14National Center of Oncology, Baku, Azerbaijan
  15. 15N.N. Petrov Research Institute of Oncology, Saint Petersburg, Russian Federation
  16. 16Tbilisi Cancer Center, Tbilisi, Georgia
  17. 17Almaty Sema Hospital, Almaty, Kazakhstan


Introduction/Background The primary aim was to determine whether different adjuvant treatment modalities (CT, RT, and CRT) improve survival outcomes in stage III endometrioid EC patients based on the specific sub-stage of the disease. The secondary aim was to assess the prognostic factors in stage III endometrioid EC.

Methodology SATEN III was a retrospective study involving 13 centers from 10 countries. Patients who had been operated on between 1998 and 2018 and diagnosed with stage III endometrioid EC were analyzed.

Results A total of 990 women overall were identified; 317 with stage IIIA, 18 with stage IIIB, and 655 with stage IIIC diseases. The median follow-up was 42 months. The 5-year DFS of patients with stage III EC by adjuvant treatment modality was 68.5% for radiotherapy (RT), 54.6% for chemotherapy (CT), and 69.4% for chemoradiation (CRT) (p=0.11). The 5-year OS for those patients was 75.6% for RT, 75% for CT, and 80.7% for CRT (p=0.48). Negative peritoneal cytology (Hazard ratio [HR]: 0.45, 95% confidence interval [CI]: 0.23–0.86; p=0.02) and performance of lymphadenectomy (HR: 0.33, 95% CI: 0.16–0.77, p=0.001) were independent predictors for improved OS for stage IIIA EC. Independent prognostic factors for better OS for stage IIIC disease were age <60 (HR: 0.50, 95%CI: 0.36–0.69, p<0.001), grade 1 or 2 disease (HR: 0.59, 95% CI: 0.37–0.94, p=0.014; and HR: 0.65, 95% CI: 0.46–0.91, p=0.014, respectively), absence of cervical stromal involvement (HR: 063, 95% CI: 0.46–0.86, p=0.004) and performance of para-aortic lymphadenectomy (HR: 0.52, 95% CI: 0.35–0.72, p<0.001).

Conclusion Although not statistically significant, CRT seemed to be a better adjuvant treatment option for stage IIIA endometrioid EC. However, we were not able to show the superiority of adjuvant CRT in stage IIIC endometrioid EC.Systematic lymphadenectomy seemed to improve survival outcomes in stage III endometrioid EC.

Disclosure Nothing to disclose.

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