Abstract
Approximately 15% of women with endometrial cancer present with high-risk disease which increases the risk of progression and death. The optimal adjuvant treatment of high-risk endometrial cancer after primary debulking surgery remains incompletely defined. Here we report the outcomes of such patients treating with sequential chemotherapy-radiotherapy at a large cancer centre in Manchester, UK.
A retrospective analysis was carried out of 111 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk patients were defined as those with FIGO 2009 stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or LVSI, stage II-III endometrioid carcinoma, or any other high-risk histological subtype with stage I-III disease. Patients were followed up for a median of 67 months to measure recurrence free survival (RFS) and overall survival (OS), as well as treatment-related toxicity.
Patients had a mean age of 67 years (range 33-82), a median body mass index (BMI) of 29.1 (range 16.3-59); the majority had endometrioid histology (48%). Seventy-six percent of patients were treated with sequential chemotherapy-radiotherapy; the reason for receiving single modality adjuvant therapy was mainly patient choice or contra-indications to treatment. Patients who received sequential chemotherapy-radiotherapy had a 5-year RFS of 70% (95% CI 60.8-80.6%) and a 5-year OS of 71.4% (95% CI 62.3-81.7%). Patients tolerated treatment well with 96% of patients completing planned sequential chemotherapy-radiotherapy treatment, and only 18% of patients had grade 3 or above adverse events.
Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was associated with good progression free and overall survival outcomes, consistent with the results of recent phase III clinical trials. Further research is needed to determine the impact of molecular subgroups on prognosis and efficacy of adjuvant therapy.
A retrospective analysis was carried out of 111 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk patients were defined as those with FIGO 2009 stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or LVSI, stage II-III endometrioid carcinoma, or any other high-risk histological subtype with stage I-III disease. Patients were followed up for a median of 67 months to measure recurrence free survival (RFS) and overall survival (OS), as well as treatment-related toxicity.
Patients had a mean age of 67 years (range 33-82), a median body mass index (BMI) of 29.1 (range 16.3-59); the majority had endometrioid histology (48%). Seventy-six percent of patients were treated with sequential chemotherapy-radiotherapy; the reason for receiving single modality adjuvant therapy was mainly patient choice or contra-indications to treatment. Patients who received sequential chemotherapy-radiotherapy had a 5-year RFS of 70% (95% CI 60.8-80.6%) and a 5-year OS of 71.4% (95% CI 62.3-81.7%). Patients tolerated treatment well with 96% of patients completing planned sequential chemotherapy-radiotherapy treatment, and only 18% of patients had grade 3 or above adverse events.
Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was associated with good progression free and overall survival outcomes, consistent with the results of recent phase III clinical trials. Further research is needed to determine the impact of molecular subgroups on prognosis and efficacy of adjuvant therapy.
| Original language | English |
|---|---|
| Journal | European Journal of Gynaecological Oncology |
| Publication status | Accepted/In press - 15 Jan 2021 |
