Combined therapy for endometrial carcinoma: Preoperative intracavitary irradiation followed promptly by hysterectomy

Ohlsen, Joel; Johnson, Glen E.; Stewart, Robert; Eltringham, James R.; Stenchever, Morton A.

doi:10.1002/1097-0142(197702)39:2<659::aid-cncr2820390243>3.0.co;2-3

Cited by 12 publications

(2 citation statements)

References 20 publications

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“…Simple total abdominal hysterectomy and bilateral salpingo-oophorectomy is favoured by most authorities and radical procedures such as Wertheim's hysterectomy have fallen into disfavour (Whitfield 1976). After total abdominal hysterectomy and bilateral salpingo-oophorectomy alone the reported incidence of vaginal vault recurrence ranges from 9.1 to 14.4% (Brady et al 1974), 16% (Shah & Green 1972) to 18% (Ohlsen et al 1977). Preliminary closure of the cervix with excision of a wide cuff of the upper vagina is commonly used to prevent this, although the value of this and other steps has not been established by any randomized trial (Lewis & Bundy 1981).…”

Section: Discussionmentioning

confidence: 99%

Use of progestogens as an adjuvant to surgery in the treatment of stage I adenocarcinoma of the uterine corpus

Moazzami¹,

Walt²,

Boyd³

1983

BJOG

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Summary. Fifty‐nine patients with proven stage I adenocarcinoma of the uterine corpus were treated by total abdominal hysterectomy and bilateral salpingo‐oophorectomy, followed by gestronal hexanoate intramuscularly for 3 months and then medroxyprogesterone acetate orally for a prolonged period. In the 7‐year period of study, there were no vaginal recurrences, but one patient suffered a recurrence in the inguinal lymph nodes and pelvis. Undesirable side effects did not occur. These results compare favourably with other reported studies in which surgery and radiotherapy were used.

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Section: Discussionmentioning

confidence: 99%

Use of progestogens as an adjuvant to surgery in the treatment of stage I adenocarcinoma of the uterine corpus

Moazzami¹,

Walt²,

Boyd³

1983

BJOG

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“…Substantial data suggests that the preferred option is postoperative intracavity irradiation of the whole vagina (1' 2' 6"18' 19' 24"25' 33"35' ss) . An increasing number of authorities believe external pelvic irradiation with or without the vaginal irradiation is also indicated in poorly differentiated, deeply invasive stage I and most stage II tumors (1,2,25,33,35,39,(44)(45)(46).…”

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confidence: 99%

The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer

Elliott

Green

Coates

et al. 1994

Int J Gynecol Cancer

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Between 1960 and 1985 hysterectomy was performed on 811 FIGO stage I and 116 stage II endometrial cancers which were divided into three groups: low-risk stage Ii (grade 1 and 2 lesions confined to the inner third of the myometrium; high-risk stage Iii (grade 3 and/or invading to the middle third of the myometrium or beyond); and FIGO stage II tumors (also high-risk). Hysterectomy was the only treatment in 492; in 145 the vaginal vault alone was radiated and in 290 the whole vagina, in each instance by an intracavity dose of 60Gy; in 34 of the latter high-risk tumors the pelvis received an additional 46Gy by external beam therapy. Forty isolated vaginal recurrences were detected; 10 in 308 low-risk and 22 in 184 high-risk tumors treated by surgery alone, and two and five in 40 low and 105 high-risk patients, respectively, who received adjuvant vault irradiation. No recurrences followed irradiation of the whole vaginal mucosa in 163 stage Ii low-risk and 40 stage II lesions and one, 9 years later, in 87 high-risk stage Iii tumors. Nearly 45% of patients with vaginal recurrence died from cancer within 1 year, 77% within 5 years and only 10% survived their recurrence 10 years. Total vaginal irradiation eliminated vaginal recurrences in low risk and reduced the incidence to 2.1% at 20 years after high-risk tumors.

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Treatment of endometrial cancer in a regional radiation therapy center.Analysis of 379 consecutive patients

McCabe

Sagerman

1979

Cancer

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Three hundred seventy-nine consecutive patients with adenocarcinoma of the corpus uteri, in whom irradiation was part of the treatment, were reviewed. The minimum follow-up was 3 years and none were lost. An increased incidence of corpus cancer in Central New York was demonstrated but could not be attributed to estrogen usage. There were 310 patients in FIGO stage I and 40 in stage II. Adenocarcinoma was reported in 319 and adenoacanthoma in 45. Overall survival was 74% and 62% at 5 and 10 years, respectively, and in stage I, 82% and 68%, respectively. Results for adenoacanthoma were similar to those for adenocarcinoma. Ten year survival was significantly better in those patients with a histologically negative hysterectomy specimen after preoperative intracavitary irradiation than in those with residual cancer. Treatment was tolerated well. This study demonstrates the results which can be obtained in a regional radiation therapy center serving patients and gynecologists from a wide geographic region operated upon in many different hospitals.

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Combined therapy for endometrial carcinoma: Preoperative intracavitary irradiation followed promptly by hysterectomy

Cited by 12 publications

References 20 publications

Use of progestogens as an adjuvant to surgery in the treatment of stage I adenocarcinoma of the uterine corpus

Use of progestogens as an adjuvant to surgery in the treatment of stage I adenocarcinoma of the uterine corpus

The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer

Treatment of endometrial cancer in a regional radiation therapy center.Analysis of 379 consecutive patients

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