The Results of Postoperative Radiotherapy for Endometrial Carcinoma

Noh, O Kyu; Shin, Seong Soo; Lee, Sang Wook; Ahn, Seung Do; Choi, Eun Kyung; Kim, Jong Hyeok; Kim, Yong Man; Nam, Joo Hyun; Mok, Jung Eun; Kim, Jong Hoon

Abstract

PURPOSE: To evaluate the outcome and prognostic factors of postoperative radiotherapy in endometrial carcinoma.
MATERIALS AND METHODS
From September 1991 to August 2003, 76 patients with endometrial carcinoma received postoperative adjuvant radiotherapy after hysterectomy at Asan Medical Center. Stage was classified as FIGO I in 41 (53.9%), II in 12 (53.9%), and III in 23 (30.3%). Histologic grade 1, 2 and 3 were in 29 (38.2%), 20 (26.3%), and 27 (35.5%) respectively. Forty two patients received both external beam radiation therapy (EBRT) and intracavitary radiation (ICR), 34 patients were treated with EBRT or ICR alone. EBRT dose was 50.4 Gy, ICR was performed in 4~6 fractions with 4~5 Gy per fraction. Median follow?up period was 51 (range 5~121) months.
RESULTS
Five-year overall survival was 89.6%. In univariate analysis, statistically significant factors to overall survival were FIGO stage, lymph node metastasis and histologic grade. In disease free survival, FIGO stage, lymph node metastasis and lymphovascular invasion were significant prognostic factors. Recurrence was seen in 11 patients. Of these, systemic failure was in 10 patients. There were no moderate to severe complications after radiation therapy.
CONCLUSION
The outcome of postoperative adjuvant radiotherapy in endometrial carcinoma was good. Main pattern of failure after postoperative radiotherapy was distant metastasis. So, adjuvant chemotherapy may help in improving outcome. Further study on chemotherapy in combined with postoperative radiotherapy will be needed, especially for patients with high risk factors such as high FIGO stage, lymphovascular invasion, and high histologic grade.