- In patients with advanced node-positive endometrial cancer undergoing surgery, adjuvant chemoradiotherapy improves disease-specific survival (DSS) in patients with nonendometrioid and grade 3 endometrioid tumors vs radiotherapy or chemotherapy alone.
- Pelvic recurrence rates were lower in patients who received radiotherapy.
Why this matters
- Multimodal treatment approach may yield superior outcomes in high-grade patients.
- 249 patients with FIGO stage IIIC endometrial cancer who underwent surgery received adjuvant radiotherapy, chemotherapy, or chemoradiotherapy (CRT) during 1985-2015.
- Funding: National Institute of Cancer, NIH.
- Median follow-up, 56 months.
- 5-year DSS was 65%.
- Adjuvant CRT significantly improved 5-year DSS vs chemotherapy in patients with grade 3 endometrioid (P=.04) and nonendometrioid tumors (67% vs 38%; P=.02).
- In patients with nonendometrioid tumors, adjuvant CRT followed by additional sequential chemotherapy prolonged 5-year DSS vs CRT alone (74% vs 50%; P=.02).
- 5-year pelvic recurrence rate was significantly lower with adjuvant radiotherapy±chemotherapy vs chemotherapy alone (5% vs 41%; P<.001>
- 5-year paraaortic node recurrence rate was lower with external field radiotherapy vs pelvic radiotherapy±chemotherapy or chemotherapy alone (0% vs 19%; P<.001>
- In patients with grade 1-2 endometrioid cancers, 5-year OS, DSS, and pelvic recurrence rates were not significantly different from radiotherapy and CRT.
- Retrospective design.