Postoperative Radiotherapy in Stage I/II Endometrial Cancer: Retrospective Analysis of 883 Patients Treated at the University of Florence. Issue 9 (1st November 2010)

• Record Type: Journal Article
• Authors: Scotti, Vieri; Borghesi, Simona; Meattini, Icro; Saieva, Calogero; Rossi, Francesca; Petrucci, Alessia; Galardi, Alessandra; Livi, Lorenzo; Agresti, Benedetta; Fambrini, Massimiliano; Marchionni, Mauro; Biti, Giampaolo
• Is Part Of: International journal of gynecological cancer. Volume 20:Issue 9(2010)
• Page Start: 1540
• Page End: 1548
• Publication Date: 2010-11-01
• Subjects: Endometrial cancer (EC) -- Postoperative radiotherapy -- External beam radiotherapy (EBRT) -- Lymphadenectomy; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1111/IGC.0b013e3181f8fa26
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : 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.