Node-Positive Adenocarcinoma of the Endometrium: Outcome and Patterns of Recurrence With and Without External Beam Irradiation

Abstract

A previous trial reported that systemic chemotherapy had a better outcome than whole abdominal radiotherapy (RT) in the treatment of patients with advanced endometrial cancer. Although these results convinced some physicians to abandon use of external beam radiotherapy in such patients, close examination of the data revealed a number of methodological deficiencies. This retrospective study investigated the outcomes, risk factors, and patterns of tumor recurrence among 71 patients with FIGO node-positive stage IIIC nonserous and nonclear cell uterine adenocarcinoma. The patients had been treated at a major cancer center between 1984 and 2005. All had received total abdominal hysterectomy and bilateral salpingo-oophorectomy and lymphadenectomy. Fifty patients were treated with regional RT (definitive pelvic or extended-field RT with or without systemic therapy) and 18 were treated with systemic chemotherapy or hormonal therapy without external beam radiotherapy. The median follow-up for all patients was 43 months and for those not dying of disease was 67 months. The Kaplan-Meier method was used to calculate survival rates and differences were analyzed with log-rank tests.