Survival after relapse in patients with endometrial cancer: results from a randomized trial☆

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

“…The reduction of radiation therapy seen in Norway is in line with the conclusion of the randomised PORTEC-1 trial 218 and ASTEC-radiation trial 182 The trend of adding chemotherapy for 9% of the Norwegian patients during the last decennium (Paper IV) and 18% of the MoMaTEC patients (Paper II and IV) thus seems to be in line with this recently developed knowledge.…”

“…Also, randomized studies reporting no survival benefit from radiotherapy may have influenced the change in treatment strategy seen over time. 182,218 In line with our 30-year perspective form Norway (Paper V), there has been an increased survival in Europe: 5-years survival has increased from 76% to 79% during 2005-2009 219 ; also a similar trend was found in Britain. 220 In contrast, a SEER study has noticed an opposite trend: worse survival of their population during 1988-2001.…”

Does robotic surgical staging of endometrial cancer compromise outcomes?

“…Similar to our study, they found fewer complications without compromise of survival outcomes in those undergoing minimally invasive versus laparotomy staging. Although our median follow-up for the robotic group was shorter, 60% of recurrences of endometrial cancer occur within 2 years, so we feel we have captured a majority of those destined to recur [19]. Based on our study, the studies by Lau et al and Fader et al, and the GOG LAP2 study, it is increasingly apparent that the initial concerns regarding an increased risk of recurrent cancer for patients undergoing minimally invasive procedures were unfounded, and that there are clear benefits with MIS in terms of operative morbidity and length of stay.…”

Controversies in the Management of Endometrial Carcinoma

“…Furthermore, there is no economic or clinical justification for the routine use of the Pap smear and systematic radiography in the follow-up of patients with endometrial carcinoma [144, 145]. Centers advocating surveillance should focus on the detection of potentially curable vaginal recurrences, since isolated vaginal-vault recurrence of endometrial carcinoma is curable in up to 87% of cases, in patients previously not exposed to radiation [146]. …”