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Adjuvant Treatment after Surgery in Stage IIIA Endometrial Adenocarcinoma

 Mee Sun Yoon  ;  Seung Jae Huh  ;  Hak Jae Kim  ;  Young Seok Kim  ;  Yong Bae Kim  ;  Joo-Young Kim  ;  Jong-Hoon Lee  ;  Hun Jung Kim  ;  Jihye Cha  ;  Jin Hee Kim  ;  Juree Kim  ;  Won Sup Yoon  ;  Jin Hwa Choi  ;  Mison Chun  ;  Youngmin Choi  ;  Kang Kyoo Lee  ;  Myungsoo Kim  ;  Jae-Uk Jeong  ;  Sei Kyung Chang  ;  Won Park 
 CANCER RESEARCH AND TREATMENT, Vol.48(3) : 1074-1083, 2016 
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PURPOSE: We evaluated the role of adjuvant therapy in stage IIIA endometrioid adenocarcinoma patients who underwent surgery followed by radiotherapy (RT) alone or chemoradiotherapy (CTRT) according to risk group.

MATERIALS AND METHODS: A multicenter retrospective study was conducted including patients with surgical stage IIIA endometrial cancertreated by radical surgery and adjuvant RT or CTRT. Disease-free survival (DFS) and overall survival (OS) were analyzed.

RESULTS: Ninety-three patients with stage IIIA disease were identified. Nineteen patients (20.4%) experienced recurrence, mostly distant metastasis (17.2%). Combined CTRT did not affect DFS (74.1% vs. 82.4%, p=0.130) or OS (96.3% vs. 91.9%, p=0.262) in stage IIIA disease compared with RT alone. Patients with age ≥ 60 years, grade G2/3, and lymphovascular space involvement had a significantly worse DFS and those variables were defined as risk factors. The high-risk group showed a significant reduction in 5-year DFS (≥ 2 risk factors) (49.0% vs. 88.0%, p < 0.001) compared with the low-risk group (< 2). Multivariate analysis confirmed that more than one risk factor was the only predictor of worse DFS (hazard ratio, 5.45; 95% confidence interval, 2.12 to 13.98; p < 0.001). Of patients with no risk factors, a subset treated with RT alone showed an excellent 5-year DFS and OS (93.8% and 100%, respectively).

CONCLUSION: We identified a low-risk subset of stage IIIA endometrioid adenocarcinoma patients who might be reasonable candidates for adjuvant RT alone. Further randomized studies are needed to determine which subset might benefit from combined CTRT.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Cha, Ji Hye(차지혜)
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