Introduction/Background Endometrial cancer is the most common gynecologic malignancy in North America. Patients who are high risk for recurrence are treated with a combination of adjuvant chemotherapy and radiation. Previous reported outcomes have been based on giving adjuvant radiation first, followed by chemotherapy. At our institution, patients are treated with chemotherapy first, followed by radiation. The purpose of this study is to review our progression-free survival (PFS) outcomes and recurrence rates and compare to established outcomes in the literature.

Methodology A retrospective chart review was performed on patients diagnosed with endometrial cancer who received adjuvant chemotherapy and radiation between 2005–2017 at The Ottawa Hospital. Inclusion criteria for the study were stage III endometrial cancers of any histology, stage I-II serous or clear cell endometrial cancers and stage IV endometrioid adenocarcinomas. PFS was defined as the time from surgery to disease recurrence or death by any cause.

Results 140 patients were included. 52 (37.1%) had endometrioid histology, 75 (53.6%) serous, and 11 (7.9%) clear cell. 41 (29.3%) were stage 1 at diagnosis, 24 (17.1%) were stage 2, 68 (48.6%) were stage 3 and 7 (5.0%) were stage 4. 130 (92.9%) completed a total of 6 cycles of chemotherapy and 92% completed radiation following chemotherapy. The median follow-up time was 63.9 months. 7 (5%) of patients were diagnosed with locoregional recurrence alone, while 25 (17.9%) had a distant recurrence alone. The estimated mean 5 year PFS was 70.1% and OS was 67.9%.

Conclusion Our sample was predominantly serous and clear cell histology. When compared to the serous subgroup analysis of the PORTEC3 trial, our sample demonstrated an improved 5 year PFS, with a similar OS. In addition, we demonstrate that delaying radiation to after completion of chemotherapy results in low locoregional recurrence rates.