Oncologic Outcomes After Adjuvant Radiotherapy for Stage II Endometrial Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-10)
The aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with adjuvant radiotherapy. We reviewed the medical records of patients who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pe...
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Published in | International journal of gynecological cancer Vol. 27; no. 7; pp. 1387 - 1392 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
BMJ Publishing Group LTD
01.09.2017
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Abstract | The aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with adjuvant radiotherapy.
We reviewed the medical records of patients who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection followed by adjuvant radiotherapy in 10 participating hospitals of the Korean Radiation Oncology Group. Most patients received adjuvant external beam radiation therapy, with a median dose of 50.4 Gy; approximately 50% of these patients received an additional brachytherapy boost, with a median dose of 18 Gy. Adjuvant chemotherapy was administered to 19 patients.
A total of 122 patients were examined. Over a median follow-up period of 62.7 months (range, 1.9-158.8 months), the 5-year overall survival (OS) and disease-free survival rates were found to be 91.1% and 85.1%, respectively. Recurrence was observed in 14 patients (11.5%), including 3 with local recurrence and 11 with distant metastases as the first site of recurrence. Univariate analysis indicated that lymphovascular invasion was related to an unfavorable OS. An age of 60 years or above, histologic grade 3, and lymphovascular invasion were identified as risk factors for OS. Because there were several risk factors related to OS, we assigned patients to a high-risk group (defined as cases with ≥1 risk factors) and a low-risk group. The 5-year OS rate of the high-risk group was significantly inferior to that of the low-risk group (82.9% vs 100%, P = 0.003).
The high-risk group had a significantly poorer survival rate than the low-risk group, and distant metastasis was the main pattern of recurrence, thus indicating that further adjuvant chemotherapy should be considered in high-risk patients. |
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AbstractList | ObjectiveThe aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with adjuvant radiotherapy.MethodsWe reviewed the medical records of patients who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection followed by adjuvant radiotherapy in 10 participating hospitals of the Korean Radiation Oncology Group. Most patients received adjuvant external beam radiation therapy, with a median dose of 50.4 Gy; approximately 50% of these patients received an additional brachytherapy boost, with a median dose of 18 Gy. Adjuvant chemotherapy was administered to 19 patients.ResultsA total of 122 patients were examined. Over a median follow-up period of 62.7 months (range, 1.9–158.8 months), the 5-year overall survival (OS) and disease-free survival rates were found to be 91.1% and 85.1%, respectively. Recurrence was observed in 14 patients (11.5%), including 3 with local recurrence and 11 with distant metastases as the first site of recurrence. Univariate analysis indicated that lymphovascular invasion was related to an unfavorable OS. An age of 60 years or above, histologic grade 3, and lymphovascular invasion were identified as risk factors for OS. Because there were several risk factors related to OS, we assigned patients to a high-risk group (defined as cases with ≥1 risk factors) and a low-risk group. The 5-year OS rate of the high-risk group was significantly inferior to that of the low-risk group (82.9% vs 100%, P = 0.003).ConclusionsThe high-risk group had a significantly poorer survival rate than the low-risk group, and distant metastasis was the main pattern of recurrence, thus indicating that further adjuvant chemotherapy should be considered in high-risk patients. The aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with adjuvant radiotherapy. We reviewed the medical records of patients who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection followed by adjuvant radiotherapy in 10 participating hospitals of the Korean Radiation Oncology Group. Most patients received adjuvant external beam radiation therapy, with a median dose of 50.4 Gy; approximately 50% of these patients received an additional brachytherapy boost, with a median dose of 18 Gy. Adjuvant chemotherapy was administered to 19 patients. A total of 122 patients were examined. Over a median follow-up period of 62.7 months (range, 1.9-158.8 months), the 5-year overall survival (OS) and disease-free survival rates were found to be 91.1% and 85.1%, respectively. Recurrence was observed in 14 patients (11.5%), including 3 with local recurrence and 11 with distant metastases as the first site of recurrence. Univariate analysis indicated that lymphovascular invasion was related to an unfavorable OS. An age of 60 years or above, histologic grade 3, and lymphovascular invasion were identified as risk factors for OS. Because there were several risk factors related to OS, we assigned patients to a high-risk group (defined as cases with ≥1 risk factors) and a low-risk group. The 5-year OS rate of the high-risk group was significantly inferior to that of the low-risk group (82.9% vs 100%, P = 0.003). The high-risk group had a significantly poorer survival rate than the low-risk group, and distant metastasis was the main pattern of recurrence, thus indicating that further adjuvant chemotherapy should be considered in high-risk patients. |
Author | Lee, Seok-Ho Lee, Jong-Hoon Yoon, Won Sup Kim, Yong Bae Jung, Jinhong Park, Won Kim, Young Seok Kim, Jin Hee Joo, Ji Hyeon Eom, Keun-Yong |
Author_xml | – sequence: 1 givenname: Jinhong surname: Jung fullname: Jung, Jinhong organization: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine; †Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; ‡Department of Radiation Oncology, St Vincent's Hospital, The Catholic University of Korea, College of Medicine, Suwon; §Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu; ∥Department of Radiation Oncology, Korea University Ansan Hospital, Ansan; ¶Department of Radiation Oncology, Gil Medical Center, Gachon Medical School, Incheon; #Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam; and Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea – sequence: 2 givenname: Young Seok surname: Kim fullname: Kim, Young Seok – sequence: 3 givenname: Ji Hyeon surname: Joo fullname: Joo, Ji Hyeon – sequence: 4 givenname: Won surname: Park fullname: Park, Won – sequence: 5 givenname: Jong-Hoon surname: Lee fullname: Lee, Jong-Hoon – sequence: 6 givenname: Jin Hee surname: Kim fullname: Kim, Jin Hee – sequence: 7 givenname: Won Sup surname: Yoon fullname: Yoon, Won Sup – sequence: 8 givenname: Seok-Ho surname: Lee fullname: Lee, Seok-Ho – sequence: 9 givenname: Keun-Yong surname: Eom fullname: Eom, Keun-Yong – sequence: 10 givenname: Yong Bae surname: Kim fullname: Kim, Yong Bae |
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CitedBy_id | crossref_primary_10_1186_s12885_021_08524_x crossref_primary_10_1016_j_brachy_2017_10_011 crossref_primary_10_1136_ijgc_2020_001797 crossref_primary_10_1016_j_clon_2022_08_034 crossref_primary_10_1111_jog_14648 crossref_primary_10_1136_ijgc_2020_001199 crossref_primary_10_3802_jgo_2020_31_e39 |
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Copyright | 2017 2017 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology. |
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Snippet | The aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with... ObjectiveThe aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma... |
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SubjectTerms | Adult Aged Chemotherapy Endometrial cancer Endometrial Neoplasms - pathology Endometrial Neoplasms - radiotherapy Endometrial Neoplasms - surgery Female Humans Hysterectomy Lymph Node Excision Medical prognosis Middle Aged Neoplasm Staging Prognosis Radiation therapy Radiotherapy, Adjuvant Retrospective Studies Risk factors Salpingo-oophorectomy Treatment Outcome |
Title | Oncologic Outcomes After Adjuvant Radiotherapy for Stage II Endometrial Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-10) |
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