Abstract
Objective:To evaluate the necessity of adjuvant therapy and other prognostic factors in high-grade uterine corpus-confined endometrial cancer (EC) with lymphadenectomy performed.Materials and Methods:This study included 120 patients who had endometrioid-type grade 3, serous-type, clear cell-type, and undifferentiated-type EC and underwent lymphadenectomy.Results:Patients with high-grade uterine corpus-confined EC who underwent lymphadenectomy were evaluated. The modality of adjuvant therapy performed was not a predictor for the site of recurrence. The loco-regional recurrence rate decreased from 9.5% to 3.8% in patients who received radiotherapy. However, this difference was not statistically significant (p=0.206). In addition, performing adjuvant chemotherapy did not alter the risk of extrapelvic recurrence. Only International Federation of Gynecology and Obstetrics 2009 stage was significant in the univariate analysis. On the other hand, age, tumor type, number of removed lymph nodes, presence of myometrial and lymphovascular space invasion, tumor size and adjuvant therapy modality were not related with disease-free survival.Conclusion:Performing adjuvant therapy and therapy modality does not improve oncologic outcomes in intermediate and high-risk patients. However, radiotherapy reduced the risk of local recurrence by more than 50%. Vaginal brachytherapy was efficient as external beam radiotherapy. Therefore, vaginal brachytherapy should be used for these patients in order to reduce loco-regional recurrence even if it is not reported to be effective on disease-free survival.
Highlights
Endometrial cancer (EC) is the most frequent cancer of the female genital tract and the fourth cancer among all cancer types[1]
Performing adjuvant chemotherapy did not alter the risk of extrapelvic recurrence
Patients whose surgeries had not been performed in our clinic, with endometrioid-type grade 1 and 2 or mixed-type adenocarcinoma, whose tumors had a sarcoma component, with synchronized primary tumor, whose surgeries had not included lymphadenectomy, who were lost during follow-up, who died in the first month after surgery, and those who underwent neo-adjuvant treatment were excluded
Summary
Endometrial cancer (EC) is the most frequent cancer of the female genital tract and the fourth cancer among all cancer types[1]. According to GLOBOCAN 2012 data, 320.000 new cases are diagnosed each year[2]. EC is mostly diagnosed at the early stage and the main treatment is surgery[3]. Five-year overall survival (OS) is over 80% for low-grade tumors in early-stage EC[4]. EC has been staged surgically according to the International Federation of Gynecology and Obstetrics (FIGO) since 1988(5). The use of adjuvant therapy in uterine corpus-confined EC is controversial. Vaginal brachytherapy (VBT) could be a type of adjuvant radiotherapy (RT) given in patients with EC because of its tolerability[9,10]. This study was designed to evaluate the necessity of adjuvant therapy and other prognostic factors in patients with high-grade uterine corpus-confined EC who underwent lymphadenectomy
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