Introduction/Background*Locally advanced endometrial cancer extending to the cervix is a rare presentation of uterine cancer (10-15%). Most of them, are stage II hidden with cervical microscopic extension discovered at the time of the pathological results. A lower percentage of stage II are diagnosed preoperatively. For the latter there, are two action plans: a) radical surgery (radical hysterectomy with bilateral salpingo-oophorectomy, pelvic lavage and lymphadenectomy), b) neoadjuvant radiotherapy followed by simple surgery (Simple hysterectomy with bilateral salpingo-oophorectomy).
The main objective was to know the overall survival, analyzed at 3 and 5 years, and the disease-free survival between those patients with a preoperative diagnosis of endometrial cancer stage II versus those patients with postoperative diagnosis.
Methodology Longitudinal cohort study with retrospective analysis was carried out in a third level hospital. Patients diagnosed with endometrial cancer stage II, FIGO 2009, were included. Study period 1998 to 2018.
Two cohorts were formed; women who initially received neoadjuvant radiation therapy followed by hysterectomy (preoperative diagnosis stage II) and women who received primary surgical followed by radiation (postoperative diagnosis stage II).
The overall survival, 3 and 5 years, and disease-free survival were analyzed.
Result(s)*125 patients were included in the study. 29 patients received neoadjuvant treatment with radiotherapy and 96 patients did not receive neoadjuvant treatment. The rate of overall survival at 3 and 5 years was 78.6% in the ‘neoadjuvant’ cohort and 86.3% and 77.9% respectively in the ‘no neoadjuvant’ cohort, not finding differences statistically significant between both groups (p= 0,761).
No differences were in terms of disease relapses, local and distance, and in terms of disease-free survival.
Conclusion*The application of neoadjuvant radiotherapy (brachytherapy plus external radiotherapy) followed simple hysterectomy in our study population, allows to match the prognosis of patients with clinical endometrial cancer stage II, initially considered less favorable.
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