Abstract
and received adjuvant high-dose-rate vaginal cuff brachytherapy. Their medical records were retrospectively reviewed in this IRB-approved study. Height and weight data were available at time of hysterectomy from which BMI was calculated (!30, $30 -!38 and $38). Following a univariate analysis, multivariable modeling was done using Cox regression analysis. Results: Median followup was 48 months (range 13-245), median age was 62 years (range 39-91) and median BMI is 33.7 (range 19.7 63.6). There were 126 patients (89.4%) with endometrioid histology, 96 patients (68%) with stage IA, 38 patients 27% with stage IB and 7 (5%) with stage II. Median brachytherapy dose was 37.5 Gy to the surface of a vaginal cylinder in 5 fractions. Only 13 patients (9.2%) received adjuvant chemotherapy. There were only 6 patients with recurrences including only one patient with isolated vaginal cuff recurrence. Due to small number of events and based on exploratory analysis, body mass index (as a continuous variable or categorical) was not a significant predictor of recurrence-free, or disease-specific survival. BMI $38 and older age were the only independent predictor of OS (p50.02 and!0.001, respectively). Five-year recurrence-free, disease-specific and overall survival for the study cohort was 93.2%, 96.3% and 89%, respectively. Conclusions: In our study, vaginal cuff control was excellent with vaginal brachytherapy. Body mass index was not a predictor of tumor recurrence or disease-specific survival in patients with early stage endometrial carcinoma who underwent surgical staging followed by adjuvant vaginal cuff HDR brachytherapy.
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