Adjuvant Chemotherapy Including Cisplatin in Endometrial Carcinoma

Abstract

To determine the outcome of patients with endometrial endometrioid adenocarcinoma following adjuvant chemotherapy, CAP (cyclophosphamide, pirarubicin and cisplatin) and EP (etoposide and cisplatin) were assigned at random to patients with Ic or more advanced stage carcinoma, and their efficacy was compared. These patients were treated by the Tokai Endometrial Cancer Study Group (Nagoya University and related institutions) between January 1992 and June 1996. The 5-year survival rate was 88.4% in the CAP group and 95.1% in the EP group; the difference between the two groups was not significant (p = 0.3496). The disease-free survival rate was 80.3% in the CAP group and 84.8% in the EP group (nonsignificant: p = 0.4533). However, the 5-year disease-free survival rates were 95.1 and 71.0% in patients with preoperative CA125 levels <35 and ≧35 IU/ml, and there was a significant difference in disease-free survival curves (p < 0.05). A significant difference was also observed in disease-free survival curves between patients with and without pelvic lymph node metastasis (5- year disease-free survival rate: 68.8 and 88.2% in patients with and without pelvic lymph node metastasis, respectively, p < 0.05). Multivariate analysis of disease- free survival showed that the preoperative CA125 level, and pelvic lymph node metastasis were significant risk factors for recurrence. In conclusion, the EP chemotherapy had no significant advantage in terms of survival and disease-free survival compared to CAP, although these rates were superior in the EP group compared to the CAP group.