Endometrial cancer: adjuvant CRT tops RT in grade 3 disease, says Canadian study

  • Albeesh R & et al.
  • Gynecol Oncol
  • 22 Nov 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Among patients with stage III endometrial cancer confined to the pelvis, adjuvant chemoradiotherapy (CRT) tops radiotherapy (RT) for OS in grade 3 disease.
  • Grade 3 disease was significantly associated with worse outcomes.

Why this matters

  • Optimal adjuvant management remains unclear in this population.

Study design

  • 144 patients diagnosed with stage IIIA, B, or C1 endometrial cancer who underwent surgical resection followed by adjuvant RT, CRT, chemotherapy, or no further treatment.
  • Funding: None disclosed.

Key results

  • Median follow-up, 61 months.
  • Patients treated with RT alone vs CRT showed similar:
    • 5-year OS: 67% vs 61% (P=.546).
    • 5-year DFS: 67% vs 51%.
    • 5-year disease-specific survival (DSS): 76% vs 65%.
  • Grade 3 disease showed significant association with worse OS (HR, 6.01; P=.001), DFS (HR, 3.16; P=.03), and DSS (HR, 3.77; P=.02).
  • Among patients with grade 3 disease (n=49), the 5-year OS rate was significantly higher with adjuvant CRT vs RT (56% vs 42%; P=.007).
  • Acute grade 3-4 toxicities were diagnosed in 6% and 35% of patients treated with adjuvant RT and CRT, respectively.

Limitations

  • Retrospective design.

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