Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial

Creutzberg, Carien L.; Putten, W L van; Koper, P.; Lybeert, Marnix L.M.; Jobsen, Jan J.; Wárlám-Rodenhuis, Carla C.; Winter, K.A De; Lutgens, Ludy; Bergh, Alfons Cm van den; Steen-Banasik, Elzbieta van de; Beerman, Herman; Lent, M. van

doi:10.1016/s0140-6736(00)02139-5

Cited by 1,608 publications

(619 citation statements)

References 36 publications

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“…Neither pelvic lymphadenectomy 10,11 nor pelvic radiotherapy 6,18,19 has a positive survival impact on endometrial adenocarcinoma. It could be postulated that this is due to underestimation of aortic LNM.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Nodal Metastasis and Isolated Aortic Metastases in Patients With Surgically Staged Endometrioid Endometrial Cancer

Sautua

Goiri²,

Calle

et al. 2015

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 99%

Incidence of Nodal Metastasis and Isolated Aortic Metastases in Patients With Surgically Staged Endometrioid Endometrial Cancer

Sautua

Goiri²,

Calle

et al. 2015

International Journal of Gynecological Cancer

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“…The two large multicenter randomized PORTEC trials have established the value of vaginal brachytherapy in high-risk EC in terms of lower locoregional recurrence, but this trial failed to demonstrate any value of external beam radiotherapy in improving overall survival or lowering the risk distant metastases while negatively impacting overall quality of life in terms of clinically significant higher levels of bowel symptoms, limitations in daily activities and lower social functioning [18–25]. Interestingly, even though vaginal brachytherapy appeared to provide a better health related quality control, sexual symptoms were equally high in both cohorts [25].…”

Section: Discussionmentioning

confidence: 99%

Surgical and systemic management of endometrial cancer: an international survey

Fotopoulou

Kraetschell

Dowdy

et al. 2014

Arch Gynecol Obstet

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Purpose To ascertain the spectrum of clinical management of endometrial carcinoma (EC) the largest international survey was conducted to evaluate and identify differences worldwide. Methods After validation of a 15-item questionnaire regarding surgical and adjuvant treatment of EC in Germany, an English-adapted questionnaire was put online and posted to all the major gynecological cancer Societies worldwide for further distribution commencing in 2010 and continued for 26 months. Results A total of 618 Institutions around the world participated: Central Europe (CE), Southern Europe (SE), Northern Europe (NE), Asia and USA/Canada/UK. Both a therapeutic and staging value was attributed to systematic pelvic and paraaortic lymph node dissection (LND) in CE (74.6 %) and in Asia (67.2 %), as opposed to USA/UK where LND was mainly for staging purposes (53.5 %; p < 0.001). LND was performed up to the renal veins in CE in 86.8 %, in Asia in 80.8 %, in USA/UK in 51.2 % and in SE in 45.1 % (p < 0.001) of cases. In advanced disease, centers from Asia were treated most with adjuvant chemotherapy alone (93.6 %), as opposed to centers in SE, CE and UK/USA that employed combination chemoradiotherapy in 90.9 % (p < 0.001) of cases. Paclitaxel/carboplatin was mostly used followed by doxorubicin/cisplatin (75 vs. 23.3 %; p < 0.001). In total, 94 % of all participants supported the concept of treating EC patients within appropriate clinical trials. Conclusions There is broad range in both the surgical and adjuvant treatment of EC across different countries. Large-scale multicenter prospective trials are warranted to establish consistent, evidence-based guidelines to optimize treatment worldwide.

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“…In clinical stage I, approximately 5-20% of patients who were treated with TAH and bilateral salpingo-oophorectomy alone develop vaginal and pelvic recurrences, which were associated with deep myometrial invasion, undifferentiated tumors, lymphovascular space invasion and advanced stage [7,8,9,10,11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

“…It was believed that adjuvant radiotherapy could achieve high local control [8,9,10], and that adjuvant chemotherapy could reduce the risk of distant recurrence [17]. Therefore, the influence of adjuvant therapy should be included in the analysis of recurrent sites.…”

Section: Introductionmentioning

confidence: 99%

Is Modified Radical Hysterectomy Needed for Patients with Clinical Stage I/II Endometrial Cancers? A Historical Control Study

Miyamoto

Takano²,

Aoyama³

et al. 2016

Oncology

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Objective: The aim of the present study was to assess whether hysterectomy with wider resection could improve survival by preventing local recurrence. Methods: Medical charts of the patients with clinical stage I/II endometrial cancers treated at our hospital between 1990 and 2009 were retrospectively analyzed. The primary endpoint was overall survival (OS), and secondary endpoints were progression-free survival (PFS) and adverse effects according to the type of hysterectomy. Results: A total of 247 patients were identified: 46 patients treated with total abdominal hysterectomy (TAH group) and 201 patients with modified radical hysterectomy (mRH group). No significant differences were observed in OS (p = 0.52) and PFS (p = 0.67) between the two groups. Also, there was no significant difference in the distribution of recurrent sites between the two groups. The patients treated with mRH had a longer operation time and more frequently developed severe adverse events, such as blood loss and lymphedema. Conclusion: In our cohorts, there were no significant differences in both PFS and OS according to surgical procedures, and the mRH group more frequently developed severe adverse events. Overall, clinical benefit was not obtained by mRH in patients with clinical stage I/II endometrial carcinomas.

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Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial

Cited by 1,608 publications

References 36 publications

Incidence of Nodal Metastasis and Isolated Aortic Metastases in Patients With Surgically Staged Endometrioid Endometrial Cancer

Incidence of Nodal Metastasis and Isolated Aortic Metastases in Patients With Surgically Staged Endometrioid Endometrial Cancer

Surgical and systemic management of endometrial cancer: an international survey

Is Modified Radical Hysterectomy Needed for Patients with Clinical Stage I/II Endometrial Cancers? A Historical Control Study

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