Abstract

The aim of this study was to determine the role of adjuvant endovaginal brachytherapy HDR (High Dose Rate) or observation, as well as identification of risk factors of tumor recurrence. The study included 178 women after radical hysterectomy. All patients belonged to the group of low- and medium-risk stage I FIGO. Analysis consisted of 3-, 5-, and 10-year OS, DFS, and LRFS in both groups. Follow-up was more than 6.5 years. The 5-OS, 5-DFS, and 5-LRFS were 93%, 96%, and 98% in the treated group and 95%, 94%, and 96% in the observed group, respectively. These differences were not statistically significant. There was a statistically significant difference in 5-OS in the treated group, between low- and medium-risk subgroups (100% versus 87.55%, p = 0.018). There was a better prognosis among the patients with FIGO IA compared to FIGO IB (5-DFS, 97 versus 86%, p = 0.047). Among the risk factors, there were only statistically significant differences in the 5-OS, between the ages of ≤ 70 years and >70 years. Use of brachytherapy may affect the reduction in the number of local recurrences at the vaginal stump (6% versus 2%). This is particularly noticeable in the low-risk subgroup (9% versus 0%).

Highlights

  • Uterine cancer is the sixth most common cancer in women in the world and the fourth most common cancer in Europe

  • Depending on the stage of cancer, exclusive observation, teleradiotherapy, brachytherapy, a combination therapy involving both of these methods, or chemotherapy are used after surgery [2]

  • A comparison of exclusive observation and brachytherapy conducted by Sorbe et al [9]

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Summary

Introduction

Uterine cancer is the sixth most common cancer in women in the world and the fourth most common cancer in Europe. It is the second most common cancer among gynecological cancers after cervical cancer in the world and first in Europe [1]. The management of endometrial cancer is complex and it is based on surgical treatment, radiotherapy, chemotherapy, and hormonal therapy. A recommended and routine surgical procedure is the total abdominal hysterectomy with bilateral salpingooophorectomy [2]. Depending on the stage of cancer, exclusive observation, teleradiotherapy, brachytherapy, a combination therapy involving both of these methods, or chemotherapy are used after surgery [2]

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