Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone

  • Rahatli, Samed (Department of Medical Oncology, Baskent University Hospital) ;
  • Dizdar, Omer (Department of Medical Oncology, Baskent University Hospital) ;
  • Kucukoztas, Nadire (Department of Medical Oncology, Baskent University Hospital) ;
  • Oguz, Arzu (Department of Medical Oncology, Baskent University Hospital) ;
  • Yalcin, Selim (Department of Medical Oncology, Baskent University Hospital) ;
  • Ozen, Ozlem (Department of Pathology, Baskent University Hospital) ;
  • Reyhan, Nihan Haberal (Department of Pathology, Baskent University Hospital) ;
  • Tarhan, Cagla (Department of Radiology, Baskent University Hospital) ;
  • Yildiz, Ferah (Department of Radiation Oncology, Hacettepe University Institute of Oncology) ;
  • Dursun, Polat (Department of Obstetrics and Gynecology, Baskent University Hospital) ;
  • Altundag, Ozden (Department of Medical Oncology, Baskent University Hospital) ;
  • Ayhan, Ali (Department of Obstetrics and Gynecology, Baskent University Hospital)
  • Published : 2014.05.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB (formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assess the outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and Methods: Sixty two patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. All patients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominal hysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection and omentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvant chemotherapy was not given to any of the patients. Results: Median age was 62 (range, 42-95). Ninety percent of the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) and one received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months). Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit. Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%) died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was 93.1%. Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates although the majority of them received no adjuvant treatment. Surgery alone may be sufficient for most patients with this stage of endometrial cancer.

Keywords

References

  1. Abu-Rustum NR, Zhou Q, Iasonos A, et al (2011). The revised 2009 FIGO staging system for endometrial cancer: should the 1988 FIGO stages IA and IB be altered? Int J Gynecol Cancer, 21, 511-6. https://doi.org/10.1097/IGC.0b013e31820cc305
  2. Cheung MR (2013). African American race and low income neighborhoods decrease cause specific survival of endometrial cancer: a SEER analysis. Asian Pac J Cancer Prev, 14, 2567-70. https://doi.org/10.7314/APJCP.2013.14.4.2567
  3. Creasman WT, Morrow CP, Bundy BN, et al (1987). Surgical pathologic spread patterns of endometrial cancer a gynecologic oncology group study. Cancer, 60, 2035-41. https://doi.org/10.1002/1097-0142(19901015)60:8+<2035::AID-CNCR2820601515>3.0.CO;2-8
  4. Creutzberg CL, van Putten WL, Koper PC, et al (2000).Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentrerandomised trial. PORTEC Study Group. Post operative radiation therapy in endometrial carcinoma. The Lancet, 355, 1404-11. https://doi.org/10.1016/S0140-6736(00)02139-5
  5. Fleming GF (2007). Systemic chemotherapy for uterine carcinoma: metastatic and adjuvant. J Clin Oncol, 25,2983-90. https://doi.org/10.1200/JCO.2007.10.8431
  6. Hogberg T, Signorelli M, de Oliveira CF, et al (2010). Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer--results from two randomised studies. Eur J Cancer,46, 2422-31. https://doi.org/10.1016/j.ejca.2010.06.002
  7. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  8. KongA, Johnson N, Kitchener HC, Lawrie TA (2012).Adjuvant radiotherapy for stage I endometrial cancer: an updated cochrane systematic review and meta-analysis. J Natl Cancer Inst, 10, 1625-34.
  9. Long KC, Zhou Q, Hensley ML, et al (2012). Patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial cancer. Gynecol Oncol, 125, 99-102. https://doi.org/10.1016/j.ygyno.2011.11.020
  10. Nout RA, Putter H, Jurgenliemk-Schulz IM, et al (2012). Five-year quality of life of endometrial cancer patients treated in the randomisedPost Operative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data. Eur J Cancer, 48, 1638-48. https://doi.org/10.1016/j.ejca.2011.11.014
  11. Scholten AN, van Putten WL, Beerman H, et al (2005). Postoperative radiotherapy for Stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review. Int J Radiat Oncol Biol Phys, 63, 834-8. https://doi.org/10.1016/j.ijrobp.2005.03.007
  12. Setakornnukul J, Petsuksiri J, Wanglikitkoon S, et al (2014). Long term outcomes of patients with endometrial carcinoma treated with radiation - Siriraj hospital experience. Asian Pac J Cancer Prev, 15, 2279-85. https://doi.org/10.7314/APJCP.2014.15.5.2279
  13. Sukumaran S, Subramaniam S, Paramasivam S, et al (2011). Risk factors predicting recurrence in operated endometrial cancer. J ClinOncol, [Epub ahead of print].
  14. Wang HL, Ren YF, Yang J, et al (2013). Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis. Asian Pac J Cancer Prev, 14, 2515-9. https://doi.org/10.7314/APJCP.2013.14.4.2515
  15. Wright JD, Barrena Medel NI, Sehouli J, Fujiwara K, Herzog TJ (2012). Contemporary management of endometrial cancer. The Lancet, 379, 1352-60. https://doi.org/10.1016/S0140-6736(12)60442-5

Cited by

  1. Comparison of Myometrial Invasion and Tumor Free Distance from Uterine Serosa in Endometrial Cancer vol.16, pp.2, 2015, https://doi.org/10.7314/APJCP.2015.16.2.519
  2. Should the Optimal Adjuvant Treatment for Patients With Early-Stage Endometrial Cancer With High-Intermediate Risk Factors Depend on Tumor Grade? vol.25, pp.8, 2015, https://doi.org/10.1097/IGC.0000000000000572
  3. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer vol.96, pp.51, 2017, https://doi.org/10.1097/MD.0000000000009223