Conservative management of stage I endometrial carcinoma after surgical staging

被引:89
作者
Straughn, JM [1 ]
Huh, WK [1 ]
Kelly, FJ [1 ]
Leath, CA [1 ]
Kleinberg, MJ [1 ]
Hyde, J [1 ]
Numnum, TM [1 ]
Zhang, YT [1 ]
Soong, SJ [1 ]
Austin, JM [1 ]
Partridge, EE [1 ]
Kilgore, LC [1 ]
Alvarez, RD [1 ]
机构
[1] Univ Alabama Birmingham, Dept Obstet & Gynecol, Div Gynecol Oncol, Birmingham, AL 35249 USA
关键词
endometrial carcinoma; surgical staging; adjuvant radiation; intermediate risk;
D O I
10.1006/gyno.2001.6494
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective. The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging. Methods. A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998. A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium. A total of 670 of 864 patients (78%) underwent comprehensive surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and peritoneal cytology. After 57 patients with high-risk histologic subtypes were excluded, 613 patients remained for analysis. Results. A total of 321 of 325 Stage IB patients (99%) did not receive adjuvant radiation. Fifteen of 321 patients (5%) recurred; 9 recurred in the pelvis or vagina. All 9 local recurrences were salvaged with whole pelvic radiation (XRT) and brachytherapy (BT). Seventy-seven patients were diagnosed with Stage IC disease; 53 (69%) received no adjuvant therapy. Four patients (8%) recurred, of which 2 recurred in the vagina. Three of 4 patients (75%) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy. For all Stage I patients, the 5-year disease-free survival was 93% and the 5-year overall survival was 98%. Conclusions. Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy. Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy. (C) 2001 Elsesier Science.
引用
收藏
页码:194 / 200
页数:7
相关论文
共 44 条
[1]  
AALDERS J, 1980, OBSTET GYNECOL, V56, P419
[2]   Endometrial carcinoma - Relative effectiveness of adjuvant irradiation vs therapy reserved for relapse [J].
Ackerman, I ;
Malone, S ;
Thomas, G ;
Franssen, E ;
Balogh, J ;
Dembo, A .
GYNECOLOGIC ONCOLOGY, 1996, 60 (02) :177-183
[3]   Cost-effectiveness of treatment of early stage endometrial cancer [J].
Ashih, H ;
Gustilo-Ashby, T ;
Myers, ER ;
Andrews, J ;
Clarke-Pearson, DL ;
Berry, D ;
Berchuck, A .
GYNECOLOGIC ONCOLOGY, 1999, 74 (02) :208-216
[4]   A comparison of treatment strategies for endometrial adenocarcinoma: Analysis of financial impact [J].
Barnes, MN ;
Roland, PY ;
Straughn, M ;
Kilgore, LC ;
Alvarez, RD ;
Partridge, EE .
GYNECOLOGIC ONCOLOGY, 1999, 74 (03) :443-447
[5]   Surgical staging of endometrial cancer: Evolution, evaluation, and responsible challenge - A personal perspective [J].
Boronow, RC .
GYNECOLOGIC ONCOLOGY, 1997, 66 (02) :179-189
[6]   Clarity and confusion regarding adjuvant radiation therapy in early endometrial cancer [J].
Cardenes, H ;
Randall, ME .
GYNECOLOGIC ONCOLOGY, 1999, 75 (01) :1-3
[7]   GOOD OUTCOME ASSOCIATED WITH A STANDARDIZED TREATMENT PROTOCOL USING SELECTIVE POSTOPERATIVE RADIATION IN PATIENTS WITH CLINICAL STAGE-I ADENOCARCINOMA OF THE ENDOMETRIUM [J].
CAREY, MS ;
OCONNELL, GJ ;
JOHANSON, CR ;
GOODYEAR, MD ;
MURPHY, KJ ;
DAYA, DM ;
SCHEPANSKY, A ;
PELOQUIN, A ;
LUMSDEN, BJ .
GYNECOLOGIC ONCOLOGY, 1995, 57 (02) :138-144
[8]  
CHEN SS, 1989, CANCER, V63, P1843
[9]   Intermediate-risk endometrial cancer - A management approach [J].
Corn, BW .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1996, 19 (06) :631-635
[10]   IMPACT OF IMPROVED IRRADIATION TECHNIQUE, AGE, AND LYMPH-NODE SAMPLING ON THE SEVERE COMPLICATION RATE OF SURGICALLY STAGED ENDOMETRIAL CANCER-PATIENTS - A MULTIVARIATE-ANALYSIS [J].
CORN, BW ;
LANCIANO, RM ;
GREVEN, KM ;
NOUMOFF, J ;
SCHULTZ, D ;
HANKS, GE ;
FOWBLE, BL .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (03) :510-515