Changes in radiotherapy indication for early-stage operated endometrial cancer. Revised staging, predictive factors. Conclusions from our own results

• Published in: Orvosi hetilap Vol. 157; no. 27; p. 1059
• Main Authors: Póti, Zsuzsa, Katona, Csilla, Szalai, Tibor, Mayer, Árpád
• Format: Journal Article
• Language: Hungarian
• Published: Hungary 03.07.2016
• Subjects: Carcinoma, Endometrioid - pathology; Carcinoma, Endometrioid - radiotherapy; Carcinoma, Endometrioid - surgery; Chemoradiotherapy, Adjuvant - standards; Endometrial Neoplasms - pathology; Endometrial Neoplasms - radiotherapy; Endometrial Neoplasms - surgery; Europe; Female; Humans; Hungary; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - diagnosis; Magnetic Resonance Imaging; Neoplasm Staging - methods; Positron-Emission Tomography; Predictive Value of Tests; Prognosis; Radiation Injuries - epidemiology; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiotherapy, Adjuvant - adverse effects; Radiotherapy, Adjuvant - standards; Randomized Controlled Trials as Topic; Rectum - radiation effects; Risk Factors; Tomography, X-Ray Computed; Urinary Bladder - radiation effects; Hungary; Europe; postoperative brachy-, and teletherapy; posztoperatív brachytherapia; recurrence; endometriumcarcinoma; metastasis; tumorrecidíva; prognosztikai tényezők; prognostic factors; külső besugárzás; endometrium carcinoma; metasztázis
• ISSN: 0030-6002
• DOI: 10.1556/650.2016.30484

Optimal postoperative radiotherapy indications for early-stage operated endometrial cancers have drastically changed with the new imaging generation (magnetic resonance imaging, positron emission tomography/computed tomography) and more detailed pathomorphology. The depth and growth of tumor invasion, presence or absence of the lymph node metastases, grading and lymphovascular invasion are the most important factors to predict the progression and to influence the prognosis. In 2016, on the basis of these, the European Gynecologist Oncology and Radiotherapy Society published a report in which they proposed unanimously indications for postoperative radio- and/or radiochemotherapy. The basis of their work was prospective multilevel randomized investigations which could avoid over- or undertreatment hazards. The results obtained by the authors of this article from 164 operated patients in early-stage endometrium carcinoma seem to be acceptable, in spite of the fact that their earlier radiotherapy indication was different and in the pathological description lymphovascular invasion was not included and the grading was not always applied.