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A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma: A Korean Radiation Oncology Group study (KROG 13-17)

Authors
 Mee Sun Yoon  ;  Won Park  ;  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  ;  Sei Kyung Chang  ;  Kang Kyoo Lee  ;  Myungsoo Kim 
Citation
 Gynecologic Oncology, Vol.138(3) : 519-525, 2015 
Journal Title
 Gynecologic Oncology 
Issue Date
2015
MeSH
Adenocarcinoma/drug therapy* ; Adenocarcinoma/pathology ; Adenocarcinoma/radiotherapy* ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy, Adjuvant ; Disease-Free Survival ; Endometrial Neoplasms/drug therapy* ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/radiotherapy* ; Endometrial Neoplasms/surgery ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Retrospective Studies ; Young Adult
Keywords
Adjuvant chemoradiotherapy ; Adjuvant radiotherapy ; Endometrial cancer
Abstract
OBJECTIVE: To investigate whether combined chemoradiotherapy (CTRT) confers a benefit for survival outcome over radiotherapy (RT) alone after primary surgery in patients with FIGO stage IIIC endometrial adenocarcinoma. METHODS: We conducted a multicenter retrospective study of patients with surgical stage IIIC endometrial cancer from 1990 to 2011. Adjuvant RT alone was performed in 85 patients (40.3%) and adjuvant CTRT in 126 patients (59.7%). Disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier method and Cox proportional hazards model. RESULTS: Stage IIIC1 and stage IIIC2 accounted for 63% and 37%, respectively. FIGO IIIC2 had a higher recurrence rate than FIGO IIIC1 (38.5% vs. 29.3%, p=0.172). Five-year OS and DFS were lower in FIGO IIIC2 than FIGO IIIC1 (85.1% vs. 76.9%, p=0.417; 71.0% vs. 59.2%, p=0.108, respectively). Eighteen patients (13.5%) in stage IIIC1 developed PALN recurrence, whereas only one (3.3%) in stage IIIC2 had PALN recurrence (p=0.001). In multivariate analysis, predictors of DFS were parametrial invasion (HR, 3.49; 95% CI, 1.83-6.64; p<0.001), higher grade (HR, 2.78; 95% CI, 1.31-5.89; p=0.008), and >3 positive pelvic nodes (HR, 1.84; 95% CI, 1.11-3.05; p=0.019). Combined CTRT did not affect DFS or OS in IIIC1 and IIIC2 compared with RT alone. CONCLUSION: CTRT showed comparable survival outcome to RT alone. Half of relapses (46%) in stage IIIC1 occurred in PALN region, whereas relapse in stage IIIC2 primarily occurred in distant metastasis (90%). Future randomized studies are needed to determine which subgroup may be most likely to benefit from CCRT.
Full Text
http://www.sciencedirect.com/science/article/pii/S0090825815300494
DOI
10.1016/j.ygyno.2015.06.030
Appears in Collections:
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)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/155720
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