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

• Published in: Journal of gynecologic oncology Vol. 30; no. 3; pp. e44 - 11
• Main Authors: Kim, Miseon, Kwon, Byung Su, Chang, Ha Kyun, Lee, Seungmee, Chang, Suk-Joon, Choi, Jin Young, Park, Sang-Yoon, Lee, Maria, Ryu, Hee-Sug, Kim, Yong Beom
• Format: Journal Article
• Language: English
• Published: Korea (South) Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 01.05.2019; 대한부인종양학회
• Subjects: Adenocarcinoma, Clear Cell - mortality; Adenocarcinoma, Clear Cell - pathology; Adenocarcinoma, Clear Cell - therapy; Adult; Aged; Aged, 80 and over; Chemotherapy, Adjuvant - mortality; Combined Modality Therapy - mortality; Cystadenocarcinoma - mortality; Cystadenocarcinoma - pathology; Cystadenocarcinoma - therapy; Cystadenocarcinoma, Papillary - mortality; Cystadenocarcinoma, Papillary - pathology; Cystadenocarcinoma, Papillary - therapy; Cystadenocarcinoma, Serous - mortality; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - therapy; Endometrial Neoplasms - mortality; Endometrial Neoplasms - pathology; Endometrial Neoplasms - therapy; Female; Humans; Hysterectomy - mortality; Middle Aged; Neoplasm Staging; Original; Radiotherapy, Adjuvant - mortality; Republic of Korea - epidemiology; Retrospective Studies; Survival Analysis; Treatment Outcome; 산부인과학; Republic of Korea; Adenocarcinoma, Clear Cell; Chemotherapy, Adjuvant; Endometrial Neoplasms; Adenocarcinoma, Papillary; Radiotherapy, Adjuvant
• ISSN: 2005-0380; 2005-0399; 2005-0399
• DOI: 10.3802/jgo.2019.30.e44

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). 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. 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. 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.