PT  - JOURNAL ARTICLE
AU  - T. HOGBERG
AU  - M. FREDSTORP-LIDEBRING
AU  - P. ALM
AU  - B. BALDETORP
AU  - G. LARSSON
AU  - C. OTTOSEN
AU  - L. SVANBERG
AU  - B. LINDAHL
ED  - ,
TI  - A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I–II endometrial cancer
AID  - 10.1136/ijgc-00009577-200405000-00004
DP  - 2004 May 01
TA  - International Journal of Gynecologic Cancer
PG  - 437--450
VI  - 14
IP  - 3
4099  - http://ijgc.bmj.com/content/14/3/437.short
4100  - http://ijgc.bmj.com/content/14/3/437.full
SO  - Int J Gynecol Cancer2004 May 01; 14
AB  - A management program for FIGO stage I–II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n = 553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n = 283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI = 93–98%) was identified. The high-risk group (n = 52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI = 65–89%). The difference in survival between the groups was highly significant (P < 0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.