Multimodal therapy improves survival in advanced node-positive endometrial cancer

  • Chapman BV & al.
  • Gynecol Oncol
  • 17 May 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Retrospective design.

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