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Impact of adjuvant treatments and risk factors on survival in 2023 FIGO stage IIB endometrial cancer patients: Turkish Gynecologic Oncology Group Study
  1. Utku Akgör1,
  2. Derman Basaran1,
  3. Mehmet Mutlu Meydanli2,
  4. Esra Kuscu3,
  5. Fuat Demirkiran4,
  6. Samet Topuz5,
  7. Muzaffer Sancı6,
  8. Ozgur Akbayır7,
  9. Murat Gultekin1,
  10. Mehmet Yavuz Salihoglu5,
  11. Huseyin Akilli3,
  12. Tugan Bese4,
  13. Zeliha Fırat2,
  14. Hamdullah Sozen5,
  15. Nejat Ozgul1 and
  16. Ali Ayhan3
    1. 1Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
    2. 2Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
    3. 3Department of Gynecologic Oncology, Baskent Universitesi Faculty of Medicine, Ankara, Turkey
    4. 4Department of Gynecologic Oncology, Istanbul University Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
    5. 5Department of Gynecologic Oncology, Istanbul University Capa Faculty of Medicine, Istanbul, Turkey
    6. 6Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
    7. 7Department of Gynecologic Oncology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
    1. Correspondence to Dr Utku Akgör, Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey; utkuakgor{at}gmail.com

    Abstract

    Objective The aim of this study was to investigate the impact of adjuvant treatments, factors influencing recurrence, and survival data in patients with 2023 International Federation of Gynecology and Obstetrics (FIGO) stage IIB endometrial cancer.

    Methods A retrospective analysis was conducted on patients with endometrial cancer who underwent surgery between 2005 and 2022 at seven different centers in Turkey. Demographic, clinicopathological, and survival data were collected and analyzed.

    Results Among 7323 patients, 565 (7.7%) were classified as 2023 FIGO stage IIB based on pathological results. Of 565 patients, 214 were followed without receiving adjuvant treatment, while 335 (95.4%) received adjuvant radiotherapy, and 16 (4.6%) received radiotherapy and chemotherapy. The locoregional recurrence rate was higher in patients with a tumor size >4 cm (p=0.038) and myometrial invasion >50% (p=0.045). In patients with distant metastasis, the recurrence rate was lower in those with myometrial invasion <50% compared with myometrial invasion ≥50% (p=0.031). The impact of adjuvant treatment on endometrial cancer patients revealed no significant differences for both disease free survival (p=0.85) and overall survival (p=0.54). Subgroup analyses showed that in patients with deep myometrial invasion, adjuvant treatment was associated with a significant increase in overall survival (p=0.044), but there was no effect on disease-free survival (p=0.12).

    Conclusions Patients with stage IIB endometrial cancer with myometrial invasion ≥50% were more likely to have locoregional and distant metastases. Adjuvant radiotherapy or chemoradiotherapy did not demonstrate an overall survival benefit in these patients.

    • Endometrium
    • Pathology

    Data availability statement

    No data are available. This study used the Turkish Society of Gynecologic Oncology database. The Committee of the present society forbids the transfer, rent, or sale of the data to any third party without prior approval. For questions about access to the data used for the present study, the contact number is +90 312 232 44 00.

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    Data availability statement

    No data are available. This study used the Turkish Society of Gynecologic Oncology database. The Committee of the present society forbids the transfer, rent, or sale of the data to any third party without prior approval. For questions about access to the data used for the present study, the contact number is +90 312 232 44 00.

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    Footnotes

    • X @BasaranDerman

    • Contributors Conception and design: UA, DB, and MMM. Acquisition of the data: EK, FD, ST, MS, OA, MG, MYS, HA, and TB. Analysis and interpretation of the data: ZF, HS, NO, and AA. Manuscript writing: UA, MMM, DB, and MG. Guarantors: MMM, NO, and AA. Manuscript review and approval: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.