RT Journal Article
SR Electronic
T1 Postoperative Radiotherapy in Stage I/II Endometrial Cancer: Retrospective Analysis of 883 Patients Treated at the University of Florence
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 1540
OP 1548
DO 10.1111/IGC.0b013e3181f8fa26
VO 20
IS 9
A1 Vieri Scotti
A1 Simona Borghesi
A1 Icro Meattini
A1 Calogero Saieva
A1 Francesca Rossi
A1 Alessia Petrucci
A1 Alessandra Galardi
A1 Lorenzo Livi
A1 Benedetta Agresti
A1 Massimiliano Fambrini
A1 Mauro Marchionni
A1 Giampaolo Biti
YR 2010
UL http://ijgc.bmj.com/content/20/9/1540.abstract
AB Introduction: The efficacy of postoperative radiotherapy (RT) in the treatment of early-stage endometrial carcinoma (EC) is still under debate. This study was aimed to review the outcome and adverse effects in patients treated for EC with postoperative RT at a single center.Methods: A total of 883 patients with pathological stages I to II EC were retrospectively analyzed. Surgery consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy, or vaginal hysteroannessiectomy in 532 patients (60.2%) with pelvic lymphadenectomy in 351 patients (39.8%). Seven hundred forty-seven patients (84.6%) underwent whole pelvic RT (WPRT) and 136 (15.4%) combined WPRT and vaginal brachytherapy (BT) boost.Results: At a median follow-up of 9 years (range, 1.2-27.6 years), we observed 10.6% disease relapse. Forty-seven patients experienced local recurrence (LR), and 38 patients experienced distant metastases (DMs). At univariate analysis, age at diagnosis (P < 0.0001), stage (P < 0.04), and histological subtype (P < 0.0001) resulted in significant prognostic factors. At multivariate analysis, histotype emerged as an independent relapse predictor (P = 0.0001). Acute WPRT-related toxicity was mild; diarrhea was the most common adverse effect (19.8%). We recorded long-term adverse effects in 7.8% of the patients.Conclusions: Our study showed that patients with early-stage EC have a good outcome in overall survival and disease-free survival. In our experience, standard surgery (including hysterectomy and bilateral salpingo-oophorectomy followed by WPRT with or without BT) showed an acceptable toxicity profile.