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

Creutzberg, C.L.; Putten, Wim L.J. van; Koper, P.; Lybeert, Marnix L.M.; Jobsen, Jan J.; Wárlám-Rodenhuis, Carla C.; Winter, Katarzyna; Lutgens, L.; Bergh, Alphons C.M. van den; Steen, Erin

doi:10.1016/s0959-8049(01)81516-1

Cited by 80 publications

(133 citation statements)

References 0 publications

Supporting

Mentioning

126

Contrasting

Unclassified

Order By: Relevance

“…In PORTEC-1, the 3-year survival after salvaging vaginal recurrence was 73% compared with pelvic (8%) and distant relapse (14%). The 5-year survival after vaginal relapse was 65% in the control group compared with 43% in the RT group [5].…”

Section: Clinical Trial Evidencementioning

confidence: 86%

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

et al. 2014

View full text Add to dashboard Cite

Endometrial cancer is the most common gynecologic malignancy in the U.S., with an increasing incidence likely secondary to the obesity epidemic. Surgery is usually the primary treatment for early stage endometrial cancer, followed by adjuvant therapy in selected cases. This includes radiation therapy [RT] with or without chemotherapy, based on stratification of patients into categories dependent on their future recurrence risk. Several prospective trials (PORTEC-1, GOG#99, and PORTEC-2) have shown that the use of adjuvant RT in the intermediate risk (IR) and the high-intermediate risk (HIR) groups decreases locoregional recurrence (LRR) but has no effect on overall survival. The ad hoc analyses from these studies have shown that an even larger LRR risk reduction was seen within the HIR group compared with the IR group. Vaginal brachytherapy is as good as external beam radiotherapy in controlling vaginal relapse where the majority of recurrence occur, and with less toxicity. In the high-risk group, multimodality therapy (chemotherapy and RT) may play a significant role. Although adjuvant RT has been evaluated in many cost-effectiveness studies, highquality data in this area are still lacking.The uptake of the above prospective trial results in the U.S. has not been promising. Implications for Practice: Several phase III randomized controlled trials have shown that adjuvant radiation for highintermediate risk early-stage endometrial cancer confers a benefit by reducing local regional recurrence with minimal added toxicity, but at increased cost and without significant overall survival benefit. This article reviews key trials regarding adjuvant radiation in early stage endometrial cancer and summarizes current clinical practice patterns and available guidelines. These facets must be considered and reviewed with each patient individually to determine the relative benefit to each patient.

show abstract

Section: Clinical Trial Evidencementioning

confidence: 86%

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Figures from 3 to 6 and Radiotherapy is the standard treatment for women with isolated vaginal recurrence and no history of radiotherapy; the complete response rate is 87% (19). Chemotherapy and surgery can be used in select patients with local extension of the disease or a large-diameter recurrence.…”

Section: Recurrent Endometrial Cancer Disseminates Via 4 Main Routesmentioning

confidence: 99%

The role of surgery in recurrent endometrial cancer

Zanfagnin

Ferrero

Biglia

et al. 2016

Expert Review of Anticancer Therapy

View full text Add to dashboard Cite

Endometrial cancer is a common gynecologic malignancy in the United States and the recurrence rate depends on stage disease at diagnosis. The spread of the disease at recurrence can occur in several areas and follow different patterns. The role of surgery at the time of recurrence is not clearly defined. The aim of this review is to fully describe the current evidence available on this topic. In particular, we will describe that surgical treatment might be recommended for 1) vaginal or pelvic recurrences; 2) retroperitoneal or localized intra-abdominal recurrence, where a maximal cytoreductive effort is more likely to be successful; or 3) isolated distant recurrences when microscopically tumor-free margins can be achieved. Cases should be evaluated individually, considering factors such as comorbidities, risks of intervention, and impact of treatment on quality of life.

show abstract

“…The use of primary radiation therapy influences sites of recurrence and survival after relapse. As documented by the Post Operative Radiation Therapy in Endometrial Carcinoma trial, survival is longer for women with recurrent disease not previously treated in the adjuvant setting with radiation therapy [4,5]. In that trial, women with stage I disease, not all of whom had complete surgical staging, were randomized to surgery alone or in combination with adjuvant pelvic radiation therapy [4,5].…”

Section: Radiation Therapy For Locally Recurrent Endometrial Cancermentioning

confidence: 99%

“…As documented by the Post Operative Radiation Therapy in Endometrial Carcinoma trial, survival is longer for women with recurrent disease not previously treated in the adjuvant setting with radiation therapy [4,5]. In that trial, women with stage I disease, not all of whom had complete surgical staging, were randomized to surgery alone or in combination with adjuvant pelvic radiation therapy [4,5]. At 3 years, the actuarial survival rate for women, after any relapse, in the nonradiation therapy group was 51%, compared with 19% for women in the adjuvant radiation therapy group (p ϭ .004) [4,5].…”

Section: Radiation Therapy For Locally Recurrent Endometrial Cancermentioning

confidence: 99%

“…In that trial, women with stage I disease, not all of whom had complete surgical staging, were randomized to surgery alone or in combination with adjuvant pelvic radiation therapy [4,5]. At 3 years, the actuarial survival rate for women, after any relapse, in the nonradiation therapy group was 51%, compared with 19% for women in the adjuvant radiation therapy group (p ϭ .004) [4,5]. After an isolated vaginal cuff recurrence, the 5-year survival rate for the nonradiated group was 65%, compared with 43% for women randomized to the adjuvant radiation therapy arm of the study [4,5].…”

Section: Radiation Therapy For Locally Recurrent Endometrial Cancermentioning

confidence: 99%

See 1 more Smart Citation

Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

Rauh‐Hain

Carmen

2010

The Oncologist

View full text Add to dashboard Cite

After completing this course, the reader will be able to:1. Discuss the role of radiation therapy for advanced stage endometrial cancer in order to differentiate between patients who should receive only radiation therapy and patients requiring surgery and/or chemotherapy in addition to radiation.2. Evaluate the role of surgery for stage IV and recurrent endometrial cancer in order to select patients most likely to benefit from cytoreductive surgery.3. Evaluate the role of chemotherapy, particularly in conjunction with radiotherapy, in advanced stage endometrial carcinoma and select appropriate candidates for multimodality therapy.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTWomen with recurrent or advanced endometrial cancer constitute a heterogeneous group of patients. Depending on previous treatment, women with recurrent endometrial cancer may be appropriate candidates for surgery, radiation therapy, hormonal therapy, or chemotherapy. Women with advanced stage disease at presentation may also be appropriate candidates for systemic and local therapies. We review the treatment options available to treat recurrent and locally advanced endometrial cancer. Treatment choice depends largely on the localization of disease, the patient's performance status and previ-

show abstract

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

Cited by 80 publications

References 0 publications

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

Adjuvant Therapy in Early-Stage Endometrial Cancer: A Systematic Review of the Evidence, Guidelines, and Clinical Practice in the U.S.

The role of surgery in recurrent endometrial cancer

Treatment for Advanced and Recurrent Endometrial Carcinoma: Combined Modalities

Contact Info

Product

Resources

About