PT  - JOURNAL ARTICLE
AU  - Bertelsen, Kamma
AU  - Ørtoft, Gitte
AU  - Hansen, Estrid Stæhr
TI  - Survival of Danish Patients With Endometrial Cancer in the Intermediate-Risk Group Not Given Postoperative Radiotherapy: The Danish Endometrial Cancer Study (DEMCA)
AID  - 10.1097/IGC.0b013e318229264e
DP  - 2011 Oct 01
TA  - International Journal of Gynecologic Cancer
PG  - 1191--1199
VI  - 21
IP  - 7
4099  - http://ijgc.bmj.com/content/21/7/1191.short
4100  - http://ijgc.bmj.com/content/21/7/1191.full
SO  - Int J Gynecol Cancer2011 Oct 01; 21
AB  - Objectives: In a prospective study during the years 1986 to 1988, the Danish Endometrial Cancer Group (DEMCA) demonstrated that postoperative radiotherapy was unnecessary for low-risk patients with stage I disease. In the present study, we evaluated in a population-based study if radiotherapy could also be omitted for intermediate-risk patients with stage I disease without loss of survival.Study Design: From 1998 to 1999, 1166 patients newly diagnosed with carcinoma of the uterus were included in this prospective nationwide study. Of these, 232 were intermediate-risk patients with stage I disease. All intermediate-risk patients received standard primary surgery (hysterectomy, bilateral salpingo-oophorectomy, and peritoneal washings), and no postoperative radiotherapy was given. Survival analyses were performed using Kaplan-Meier survival estimates. The results were compared to the 1986-1988 DEMCA data.Results: The 5-year overall survival (OS) rate for the entire population was 77% (stages I-IV). The patients with stage I disease were divided into low-, intermediate-, and high-risk; the OS rates were 91%, 78%, and 62%, and the endometrial cancer-specific survival rates were 97%, 87%, and 72%, respectively. Using patients' age, tumor grade, myometrial invasion, we divided the intermediate-risk group into "high risk" intermediate and "low-risk" intermediate with OS rates of 70% and 90% and cancer-specific survival of 81% and 96%, respectively. The OS rate (78%) of the intermediate-risk group after radiation had been omitted was comparable to the OS rate (79%) of the intermediate-risk group in the earlier DEMCA (1986-1988) study where postoperative radiation was still the standard of care.Conclusion: We conclude that in a population-based study, radiotherapy can be omitted for intermediate-risk patients with stage I endometrial cancer without loss of survival.