Ozgul N, et al. - Researchers here determined the effect of different surgical approaches, adjuvant therapy, and pathological characteristics on oncological outcomes in patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer (EC). In this study, adjuvant external beam radiotherapy ± vaginal brachytherapy [VBT] were associated with increased disease-free survival (DFS) but not overall survival (OS) in stage II EC. However, findings did not demonstrate the benefit of VBT alone on DFS. Only age was found to be an independent risk factor for OS. For patients with uterus-confined disease, type of hysterectomy and histologic subtype of the tumor improved neither DFS nor OS in the study group.

Methods

• Researchers performed a multicenter, retrospective department database review at 5 gynecologic oncology centers in Turkey to identify patients with FIGO 2009 stage II EC who underwent surgical staging between 2002 and 2015 .

Results

• Researchers analyzed original pathology reports of 4,867 patients who underwent surgical treatment for EC.
• Two hundred and fifty FIGO stage II patients comprised the study group.
• Two hundred and three (81.2%) had endometrioid and 47 (18.8%) had nonendometrioid histologic subtype of EC among these patients.
• Type I hysterectomy was performed on 199 patients (79.6%) and radical hysterectomy was performed on the remaining 51 patients (20.4%).
• Adjuvant therapy including radiotherapy (pelvic external beam radiotherapy and/or vaginal brachytherapy [VBT]) and/or platinum-based chemotherapy was administered to 208/250 patients (83.2%).
• In 29 patients disease recurred (11.6%).
• For the entire cohort, the 5-year DFS and OS were 82% and 85%, respectively.
• In multivariate analysis, only adjuvant treatment (P=0.001; hazard ratio, 4.02; 95% confidence interval, 1.72–9.36) was found to have significant association with DFS.
• Multivariate analysis revealed that only age older than 60 years (P=0.01; hazard ratio, 3.03; 95% confidence interval, 1.3–7.04) was an independent risk factor for OS.
• However, observations revealed no differences in terms of OS when evaluated by grade, histology, tumor size, type of hysterectomy, or adjuvant treatment.