J Gynecol Oncol.  2019 May;30(3):e44. 10.3802/jgo.2019.30.e44.

Survival outcomes of adjuvant radiotherapy and chemotherapy in women with stage I serous papillary and clear cell carcinoma of the endometrium: a Korean multicenter study

• Kim M
• Kwon BS
• Chang HK
• Lee S
• Chang SJ
• Choi JY
• Park SY
• Lee M
• Ryu HS
• Kim YB

• KMID: 2440513
• DOI: http://doi.org/10.3802/jgo.2019.30.e44

Abstract

OBJECTIVE
To compare the survival outcomes of adjuvant radiotherapy and chemotherapy in women with uterine-confined endometrial cancer with uterine papillary serous carcinoma (UPSC) or clear cell carcinoma (CCC).
METHODS
Medical records of 80 women who underwent surgical staging for endometrial cancer were retrospectively reviewed. Stage I UPSC and CCC were pathologically confirmed after surgery. Survival outcomes were compared between the adjuvant radiotherapy and chemotherapy groups.
RESULTS
Fifty-four (67.5%) and 26 (32.5%) women had UPSC and CCC, respectively. Adjuvant therapy was administered to 59/80 (73.8%) women (25 radiotherapy and 34 chemotherapy). High preoperative serum cancer antigen-125 level (25.1±20.2 vs. 11.5±6.5 IU/mL, p < 0.001), open surgery (71.2% vs. 28.6%, p=0.001), myometrial invasion (MI) ≥1/2 (33.9% vs. 0, p=0.002), and lymphovascular space invasion (LVSI; 28.8% vs. 4.8%, p=0.023) were frequent in women who received adjuvant therapy compared to those who did not. However, the histologic type, MI ≥1/2, and LVSI did not differ between women who received adjuvant radiotherapy and those who received chemotherapy. The 5-year progression-free survival (78.9% vs. 80.1%, p>0.999) and overall survival (77.5% vs. 87.8%, p=0.373) rates were similar between the groups. Neither radiotherapy (hazard ratio [HR]=1.810; 95% confidence interval [CI]=0.297-11.027; p=0.520) nor chemotherapy (HR=1.638; 95% CI=0.288-9.321; p=0.578) after surgery was independently associated with disease recurrence.
CONCLUSION
Our findings showed similar survival outcomes for adjuvant radiotherapy and chemotherapy in stage I UPSC and CCC of the endometrium. Further large study with analysis stratified by MI or LVSI is required.

Keyword

Endometrial Neoplasms; Adenocarcinoma, Papillary; Adenocarcinoma, Clear Cell; Chemotherapy, Adjuvant; Radiotherapy, Adjuvant

MeSH Terms

Adenocarcinoma, Clear Cell
Adenocarcinoma, Papillary
Chemotherapy, Adjuvant
Disease-Free Survival
Drug Therapy*
Endometrial Neoplasms
Endometrium*
Female
Humans
Medical Records
Radiotherapy
Radiotherapy, Adjuvant*
Recurrence
Retrospective Studies