Choosing the right adjuvant therapy for stage III-IVA endometrial cancer: A comparative analysis of chemoradiotherapy and chemotherapy
- Authors
- Kim, Hyun Ju; Lee, Joongyo; Lee, Kwang-Beom; Sung, KiHoon; Kim, Yong Bae; Kim, Young Saing
- Issue Date
- Mar-2024
- Publisher
- ACADEMIC PRESS INC ELSEVIER SCIENCE
- Keywords
- Adjuvant therapy; Stage III-IVA endometrial cancer; Radiotherapy; Chemotherapy; Locally advanced
- Citation
- GYNECOLOGIC ONCOLOGY, v.182, pp 39 - 44
- Pages
- 6
- Journal Title
- GYNECOLOGIC ONCOLOGY
- Volume
- 182
- Start Page
- 39
- End Page
- 44
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/90819
- DOI
- 10.1016/j.ygyno.2024.01.017
- ISSN
- 0090-8258
1095-6859
- Abstract
- Objective. The optimal adjuvant treatment for patients with locally advanced endometrial cancer (EC) remains debatable. We comparatively analyzed recurrence patterns and survival outcomes in patients with stage III-IVA EC treated with adjuvant chemotherapy (CT) exclusively or combined with radiotherapy (CRT). Methods. We retrospectively analyzed 184 patients treated for stage III-IVA EC at 2 tertiary institutions between 2010 and 2021. All patients underwent standard primary surgery and received either CT alone (n = 89) or CRT (n = 95) as an adjuvant treatment. We compared the failure patterns, recurrence -free survival (RFS), and overall survival (OS) between the CT and CRT groups. Results. The median follow-up period was 54.8 months. Most patients underwent pelvic (94.6%) or paraaortic (75.5%) lymphadenectomies. The 5 -year RFS was 69.2% with CRT versus 56.3% with CT (P = 0.038), and 5 -year OS was 86.1% versus 78.9% (P = 0.357). Pelvic and para-aortic recurrence rates were significantly higher in the CT group (pelvic: 29.2%; para-aortic: 20.2%) than in the CRT group (pelvic: 10.5%; para-aortic: 6.3%). The CRT group showed a higher rate of distant recurrence (CRT, 23.2% vs. CT, 14.6%) however, the 5 -year cumulative incidence of distant recurrence was not significantly different between the two groups (CRT, 28% vs. CT, 35%). Conclusions. This study highlights the potential benefits of adjuvant CRT in patients with stage III-IVA EC. The incorporation of molecular classification is necessary to derive optimal personalized adjuvant treatment strategies for this patient population. (c) 2024 Elsevier Inc. All rights reserved.
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