Survival and Disease Relapse in Surgical Stage I Endometrioid Adenocarcinoma of the Uterus After Adjuvant Vaginal Vault Brachytherapy

Jaggi, Vinita Kumar; Nin, Chia Yin; Kuei, Lim Yong; Hs, Khoo Tan; Yeo, Reuben J.; Lam, Philip Yam Kwai

doi:10.1111/igc.0b013e3181d7ce94

Cited by 11 publications

(7 citation statements)

References 19 publications

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“…In addition, it is commonly expected that pelvic EBRT would contribute more to postoperative LEL than vaginal brachytherapy. Indeed, the incidence of lymphedema after adjuvant vaginal brachytherapy ranges from 3.7% to 11.1% [23,25], which is relatively low compared to 25.5% to 71.4% after adjuvant pelvic EBRT [4,10], except one study that reported lower incidence of LEL after pelvic EBRT than after vaginal brachytherapy [14]. However, to our knowledge, this is the first study to perform direct comparison of the risk of LEL following pelvic EBRT and vaginal brachytherapy and to show that pelvic EBRT is associated with higher risk of postoperative LEL.…”

Section: Discussionmentioning

confidence: 99%

Lower Extremity Lymphedema in Gynecologic Cancer Patients: Propensity Score Matching Analysis of External Beam Radiation versus Brachytherapy

Chang

Kang

et al. 2019

Cancers

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The goal of this study is to compare the risk of lower extremity lymphedema (LEL) between pelvic external beam radiation therapy (EBRT) and vaginal brachytherapy, and to identify risk factors for LEL in gynecologic cancer patients treated with adjuvant radiation therapy (RT) after radical surgery. A total of 263 stage I–III gynecologic cancer patients who underwent adjuvant RT were retrospectively reviewed. One-to-one case-matched analysis was conducted with propensity scores generated from patient, tumor, and treatment characteristics. Using the risk factors found in this study, high- and low-risk groups were identified. With a median follow-up of 36.0 months, 35 of 263 (13.3%) patients developed LEL. In multivariate analysis, laparoscopic surgery (HR 2.548; p = 0.024), harvesting more than 30 pelvic lymph nodes (HR 2.246; p = 0.028), and para-aortic lymph node dissection (PALND, HR 2.305; p = 0.014) were identified as independent risk factors for LEL. After propensity score matching, the LEL incidence of the brachytherapy group was significantly lower than the EBRT group (p = 0.025). In conclusion, high-risk patients with risk factors such as laparoscopic surgery, harvesting more than 30 pelvic lymph nodes, PALND, and adjuvant pelvic EBRT require closer observation for LEL.

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Section: Discussionmentioning

confidence: 99%

Lower Extremity Lymphedema in Gynecologic Cancer Patients: Propensity Score Matching Analysis of External Beam Radiation versus Brachytherapy

Chang

Kang

et al. 2019

Cancers

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“…Moreover, the overall (25.5%) and distant (17%) recurrence rates in patients with LVSI-positive EEC next to 2 to 3 risk factors who received adjuvant radiotherapy were much higher than those of patients with comparable risk factors and treatment who were not selected based on the presence of LVSI, as assessed by the primary pathologist. 5,12,14 In our study, all patients who died of endometrial cancer had recurrent disease, and all but one had a distant component. A group of patients who did exceptionally well were those with grade 1 EEC.…”

Section: Discussionmentioning

confidence: 57%

“…12,13 By contrast, other studies showed that VBT is equally effective to EBRT in patients with endometrial cancer and LVSI. 7,14 In the presence of LVSI, both lymphadenectomy and systemic treatment have been proposed. 3,15,16 So far, the implications of LVSI in patients with stage I EEC on either primary or adjuvant treatment have not been well established.…”

mentioning

confidence: 99%

Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

Putten

Geels

Ezendam

et al. 2015

International Journal of Gynecological Cancer

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“…41,53 Other studies comparing EBRT with HDIVRT have reported excellent recurrence-free and overall survival rates. 54 These findings suggest that early stage endometrial cancer patients can avoid the high morbidity associated with EBRT by receiving HDIVRT. 52 The PORTEC-2 Trial did confirm, however, that HDIVRT patients experience vaginal toxicities (dryness, tightening, and shortened vagina) and dyspareunia.…”

Section: Cancer Treatment and Sexualitymentioning

confidence: 81%

Contemporary Quality of Life Issues Affecting Gynecologic Cancer Survivors

Carter

Penson

Barakat

et al. 2012

Hematology/Oncology Clinics of North America

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Gynecologic cancers account for approximately 11% of the newly diagnosed cancers in women in the United States and 18% in the world.1 The most common gynecologic malignancies occur in the uterus and endometrium (53%), ovary (25%), and cervix (14%).2 Cervical cancer is most prevalent in premenopausal women, during their childbearing years, whereas uterine and ovarian cancers tend to present in the perimenopausal or menopausal period. Vaginal and vulvar cancers and malignancies arising from gestation, or gestational trophoblastic neoplasms, occur to a lesser extent. Regardless of cancer origin or age of onset, the disease and its treatment can produce short- and long-term sequelae (ie, sexual dysfunction, infertility, or lymphedema) that adversely affect quality of life (QOL). This article outlines the primary contemporary issues or concerns that may affect QOL and offers strategies to offset or mitigate QOL disruption. These contemporary issues are identified within the domains of sexual functioning, reproductive issues, lymphedema, and the contribution of health-related QOL (HRQOL) in influential gynecologic cancer clinical trials.

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Survival and Disease Relapse in Surgical Stage I Endometrioid Adenocarcinoma of the Uterus After Adjuvant Vaginal Vault Brachytherapy

Abstract: This treatment has excellent survival rates with acceptable morbidity, and recurrence is mostly distant.

Cited by 11 publications

References 19 publications

Lower Extremity Lymphedema in Gynecologic Cancer Patients: Propensity Score Matching Analysis of External Beam Radiation versus Brachytherapy

Lower Extremity Lymphedema in Gynecologic Cancer Patients: Propensity Score Matching Analysis of External Beam Radiation versus Brachytherapy

Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

Contemporary Quality of Life Issues Affecting Gynecologic Cancer Survivors

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