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Is Adjuvant Radiotherapy Worth Giving in Surgically Resected Endometrial Cancer?

Issue: Vol.9, No.4 - October 2010

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Article Type: Manuscript

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  1. Dr Emmad E. Habib
    MD
    Faculty of Medicine, Department of Clinical Oncology, Cairo University
  2. Ezzat S. Fahmy

Purpose: To better understand the potential risks and benefits of adjuvant radiotherapy in patients with surgically resected endometrial cancer and to identify prognostic factors.

Methods & Materials: A chart review identified 64 patients with stage I and II endometrial carcinoma, treated at the Kasr El-Eini Centre of Clinical Oncology between 2002 and 2007. The median duration of followup was 27 months, and patient ages ranged from 38 to 80 years. Twenty-four patients had stage IA grade 2-3, 16 had stage IB grade 2, and 8 had stage IC grade 1 disease. Sixteen cases had stage II disease. All patients underwent radical surgery, 44 of those received post-operative radiotherapy. We determined the outcome of adjuvant treatment with postoperative pelvic radiotherapy or surgery alone, comparing loco regional control, overall survival, and treatment-related morbidity.

Results: There was no statistically significant survival difference between the surgery-only and surgery-plus radiation groups in intermediate to high risk stage I and II endometrial cancer patients (p = 0.09). The 3-year overall survival rates were 79% in the irradiated group and 56% in the surgery only group, respectively. Univariate analysis of prognostic factors showed that hypertension influenced survival rate (p = 0.034). However, on multivariate analysis radiotherapy was the only independent factor affecting overall survival with an Odds Ratio (OR) of 6.9 and 95% confidence interval (CI) of 1.6-30.2.

Conclusions: The survival rate was higher and the relapse rate was lower in surgically resected high risk stage I and II endometrial cancer patients receiving radiotherapy. Moreover, on multivariate analysis radiotherapy was the only independent factor affecting overall survival with an Odds Ratio (OR) of 6.9 and 95% confidence interval (CI) of 1.6-30.2. According to our data it seems that pelvic radiotherapy is of benefit for high-risk stage I and II endometrial cancer.

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