Recurrence and survival of patients with stage III endometrial cancer after radical surgery followed by adjuvant chemo- or chemoradiotherapy: a systematic review and meta-analysis

Abstract

Objective To compare recurrence and survival in patients with stage III endometrial cancer after radical surgery, followed by either adjuvant chemoradiotherapy (ACR) or adjuvant chemotherapy (AC). Methods We searched for relevant studies in PubMed Central, Embase and the Cochrane Central Register of Controlled Trials. Data were pooled on rates of recurrence as well as rates of progression-free, disease-free and overall survival. Heterogeneity was evaluated using the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity. Results Data from 18,375 patients in 15 retrospective studies and one randomized controlled trial were meta-analyzed. Compared to the AC group, the ACR showed significantly lower risk of local recurrence (OR 0.43, 95%CI 0.32–0.59) and total recurrence (OR 0.72, 95%CI 0.58–0.89). ACR was also associated with significantly better overall survival (HR 0.66, 95%CI 0.57–0.76), progression-free survival (HR 0.56, 95%CI 0.39–0.81) and disease-free survival (HR 0.66, 95%CI 0.53–0.83). Conclusions Adding adjuvant radiotherapy to adjuvant chemotherapy after radical surgery may significantly reduce risk of local and overall recurrence, while significantly improving survival of patients with stage III endometrial cancer.

Nab-Paclitaxel-Based Systemic Approach to Achieving Complete Remission for Relapsed Stage III Endometrial Carcinoma: Insights From the Indian Subcontinent

“…In high-grade tumors, increased nuclear atypia, pleomorphism, and irregular chromatin clustering are also observed [4]. The primary treatment modalities for EC in relapsed cases, typically include radical surgery along with lymph node dissection or radical radiotherapy and still have a five-year overall survival of less than 20% [5]. This case report presents the therapeutic trajectory of a patient in their 60s who achieved complete remission from recurrent inoperable stage III endometrial carcinoma.…”