Abstract
The data on the adjuvant therapy of endometrial cancer (EC) are inconsistent. Recent studies of this topic such as PORTEC-3, GOG-258 and GOG-249 investigated the value of adjuvant radiotherapy, adjuvant chemotherapy and combined adjuvant chemoradiotherapy followed by chemotherapy in patients with endometrial cancer and an increased risk of recurrence. With this statement, the Uterus Committee of the Gynaecological Oncology Working Group (AGO) wishes therefore to interpret the new data and discuss them against the background of the new S3 guideline “Diagnosis, treatment and follow-up of patients with endometrial cancer”.
Highlights
The data on the adjuvant therapy of endometrial cancer (EC) are inconsistent. Recent studies of this topic such as PORTEC‐3, Gynecologic Oncology Group (GOG)-258 and GOG-249 investigated the value of adjuvant radiotherapy, adjuvant chemotherapy and combined adjuvant chemoradiotherapy followed by chemotherapy in patients with endometrial cancer and an increased risk of recurrence
In the Postoperative Radiotherapy in Endometrial Cancer (PORTEC)-1 study published in 2011, doctors in the Netherlands showed that locoregional control is significantly improved by percutaneous pelvic radiation with 46 Gray (Gy) after hysterectomy and bilateral adnexa extirpation in women with unknown lymph node status and an intermediate or high-intermediate risk level
Even if one of the two study endpoints (FFS) was reached after statistical adjustment, the authors conclude from these results that chemoradiotherapy cannot be recommended as the new standard for patients with high-risk EC in FIGO stage I and II
Summary
In the Postoperative Radiotherapy in Endometrial Cancer (PORTEC)-1 study published in 2011, doctors in the Netherlands showed that locoregional control is significantly improved by percutaneous pelvic radiation with 46 Gray (Gy) after hysterectomy and bilateral adnexa extirpation in women with unknown lymph node status and an intermediate or high-intermediate risk level (Fédération Internationale des Gynécologues et Obstétriciens [FIGO] endometrioid EC stage IA (in the current version) with < 50 % myometrial infiltration depth, G2 or G3, or FIGO stage IB with > 50 % myometrial infiltration depth, G1 or G2 (vaginal recurrence: 11 vs 2.5 %). Even if one of the two study endpoints (FFS) was reached after statistical adjustment, the authors conclude from these results that chemoradiotherapy cannot be recommended as the new standard for patients with high-risk EC in FIGO stage I and II.
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