Stage IVB endometrial cancer confined to the abdomen: is chemotherapy superior to radiotherapy?

• Published in: European journal of gynaecological oncology Vol. 37; no. 2; p. 226
• Main Authors: Cirik, D Akdag, Karalok, A, Ureyen, I, Tasci, T, Koc, S, Turan, T, Tulunay, G
• Format: Journal Article
• Language: English
• Published: Italy 2016
• Subjects: Adenocarcinoma, Clear Cell - drug therapy; Adenocarcinoma, Clear Cell - pathology; Adenocarcinoma, Clear Cell - radiotherapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Carcinoma, Endometrioid - drug therapy; Carcinoma, Endometrioid - pathology; Carcinoma, Endometrioid - radiotherapy; Chemoradiotherapy, Adjuvant - methods; Chemotherapy, Adjuvant - methods; Cisplatin - administration & dosage; Cytoreduction Surgical Procedures; Disease-Free Survival; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - pathology; Endometrial Neoplasms - radiotherapy; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Neoplasm Staging; Neoplasms, Cystic, Mucinous, and Serous - drug therapy; Neoplasms, Cystic, Mucinous, and Serous - pathology; Neoplasms, Cystic, Mucinous, and Serous - radiotherapy; Ovariectomy; Paclitaxel - administration & dosage; Radiotherapy, Adjuvant - methods; Retrospective Studies; Salpingectomy
• ISSN: 0392-2936
• DOI: 10.12892/ejgo2831.2016

To determine the impact of clinical variables and adjuvant therapy on survival in patients with Stage IVB endometrial cancer (EC) confined to abdomen.
A total of 65 patients were included. Curative chemotherapy was defined as using only chemotherapy (platin based) or sandwich therapy. Patients receiving only radiotherapy had standard pelvic radiotherapy and extended-field radiotherapy when necessary.
The optimal cytoreduction was achieved in 89.3% of patients. With a median follow-up of 18 months, two-year progression free survival (PFS) and overall survival (OS) were calculated as 33.4% and 42.2%, respectively. Optimal cytoreduction provided more longer PFS and OS compared to suboptimal cytoreduction. In univariate analysis, curative chemotherapy instead of radiotherapy improved the two-year PFS and two-year OS. Type of adjuvant therapy, tumor grade, and peritoneal cytology were found as the independent prognostic factors for PFS. Peritoneal cytology, adnexal involvement, and adjuvant therapy were independent prognostic factor for OS.
Curative chemotherapy significantly improved both two-year PFS and OS in patients with Stage IVB endometrial disease confined to abdomen over only radiotherapy.