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

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

doi:10.1016/s1278-3218(00)00080-9

Cited by 424 publications

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“…Four-year endpoints were arbitrary, and used to contrast with prior randomized clinical trials. 11,12 Progression-free survival was measured to the date of disease progression or death, or to date of last contact for patients alive and progressionfree. Endometrial cancer-related survival was measured to the date of death associated with documented endometrial disease progression.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

Martra

Kunos

Gibbons

et al. 2008

American Journal of Obstetrics and Gynecology

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Objective-To determine the impact of patient weight on frequency of surgical staging lymphadenectomy and pelvic radiation. Adverse effects, disease relapse, and survival outcomes were investigated.Study Design-Records of 766 women undergoing surgery for presumed corpus-confined endometrial cancer were reviewed. Body mass index (BMI) was calculated categorizing women as obese (BMI ≥ 30) or nonobese (BMI < 30). Radiation-related toxicity was retrospectively scored. Median duration of follow-up was 38 months. Chi-square, logistic regression, correlation, KaplanMeier and Cox multivariate proportional hazards were used for analysis.Results-Lymphadenectomy was completed as often in nonobese as obese women (p=0.24). Adjuvant pelvic radiation treatment was administered more often in nonobese women (p=0.01). Among 681 women with endometrioid histopathology, four-year cancer-related survival in obese women was 10 percent higher than all cause mortality, compared to 6 percent in nonobese women.Conclusion-Obesity was not a barrier to lymphadenectomy, but did influence adjuvant pelvic radiation use.CORRESPONDING AUTHOR and REPRINT REQUESTS: Vivian von Gruenigen, MD,

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Section: Discussionmentioning

confidence: 99%

Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

Martra

Kunos

Gibbons

et al. 2008

American Journal of Obstetrics and Gynecology

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“…93 The exception is an isolated vaginal recurrence where radiation therapy in former radiation naïve patients has a similar survival as if radiation is administered as a primary adjuvant treatment. 94 One study (GOG 19) regarding patients with measurable recurrent or advanced endometrial cancer tested continuously administered tamoxifen citrate and progestin intermittently found a significant longer survival for patients with pre-treatment tumour biopsies positive for estrogen receptor with HR 0.47 (95% CI 0.24-0.92), median overall survival of 8 months versus 19 months with negative ER. 95 The searching for better treatment regimens has prompted investigation of underlying molecular alterations important in endometrial carcinogenesis.…”

Section: Systemic Therapymentioning

confidence: 99%

Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective

Trovik

Mauland

Werner

et al. 2012

Gynecologic Oncology

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“…Adjuvant pelvic irradiation following surgery without lymphadenectomy only reduced the rate of vaginal stump recurrence, but did not improve the survival rate (Aalders et al, 1980;Creutzberg et al, 2000); in patients who underwent this treatment, distant metastases developing from undetected and untreated paraaortic nodes that were located outside of the irradiation field may decrease their survival; paraaortic node metastases were found in 32 -78% of the patients with pelvic node involvement (Chen et al, 1985;Morrow et al, 1991;Yokoyama et al, 1997;Onda et al, 1997;Hirahatake et al, 1997) and in 16 -44% of the patients with deep (4½) myometrial invasion (Morrow et al, 1991;Yokoyama et al, 1997;Hirahatake et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…Lymphadenectomy is recommended for predicting patients prognosis and for tailoring postoperative therapy in many studies (Chuang et al, 1995;Kilgore et al, 1995;Blythe et al, 1997;Yokoyama et al, 1997). However, Creutzberg et al (2000) stated that lymphadenectomy cannot be considered a standard procedure because its benefit is unclear. Since lymphadenectomy is performed mainly with diagnostic intent, positive lymph nodes are often left unresected (Creasman et al, 1987); therefore the therapeutic benefit of lymphadenectomy, which should be evaluated by resection of macroscopically positive nodes as well as microscopically positive nodes, is still unclear.…”

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confidence: 99%

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Lymphadenectomy and adjuvant therapy in endometrial carcinoma: role of adjuvant chemotherapy

2002

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To evaluate the therapeutic benefit of lymphadenectomy and adjuvant therapy, in particular chemotherapy, we retrospectively analysed survival rates and patterns of recurrence of endometrioid adenocarcinoma in 106 patients who underwent surgery including retroperitoneal lymphadenectomy. Adjuvant chemotherapy was administered to 46 patients (42 received a platinumbased regimen) and pelvic irradiation to 12. The 5-year survival rate of 23 patients with lymph node metastasis was worse than that of patients without lymph node metastasis (60% vs 96%, P50.0001). Recurrence was observed in 14 patients (10 patients with chemotherapy, two with irradiation, and two without adjuvant therapy); the first site of recurrence was in distant sites in 12 patients; recurrence in the pelvic sidewall or exclusively in lymph nodes was not observed. The 5-year survival rate of 18 patients with lymph node metastasis treated with chemotherapy, was 61% including all 14 with macroscopically positive nodes and all nine with paraaortic metastasis. Of seven patients with bulky positives nodes, three patients with bulky paraaortic nodes died of the disease, three of the four patients with bulky pelvic but without bulky paraaortic nodes had no recurrence. In summary, lymphadenectomy may afford a survival benefit via the debulking of macroscopically positive nodes, and the predominance of distant recurrences suggests that chemotherapy is a suitable choice as an adjuvant therapy in endometrial carcinoma after lymphadenectomy.

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

Cited by 424 publications

References 0 publications

Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective

Lymphadenectomy and adjuvant therapy in endometrial carcinoma: role of adjuvant chemotherapy

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