open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2014-01-12
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The effect of lymphadenectomy and radiotherapy on recurrence and survival in endometrial carcinoma. Experience in a population reference centre

Meritxell Arenas, Marina Gascón, Àngels Rovirosa, Víctor Hernández, Francesc Riu, Iolanda López, Angel Montero, Sebastià Sabater
DOI: 10.1016/j.rpor.2014.09.003
·
Rep Pract Oncol Radiother 2015;20(1):50-56.

open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2014-01-12

Abstract

Aim

To evaluate the effect of lymphadenectomy and/or radiotherapy on recurrence and survival patterns in endometrial carcinoma (EC) in a radiotherapy reference centre population.

Material and Methods

A retrospective population-based review was conducted on 261 patients with stages I–III EC. Univariate and multivariate analyses were carried out. Both recurrence and survival were analysed according to patient age, FIGO stage, tumour size, myometrial invasion, tumour grade, lymphadenectomy, external beam irradiation (EBI), and brachytherapy (BT).

Results

Median age: 64.8 years. Median follow-up: 151 months. The following treatments were administered: surgery, 97.32%; lymph-node dissection, 54.4%; radiotherapy, 162 patients (62%) (EBI and BT: 64.1%, BT alone: 30.2%, EBI alone: 5.6%).

Twenty-six patients (9.96%) suffered loco-regional recurrence, whilst 27 (10.34%) suffered distant failure. The 5-year overall survival (OS) for all stages was 80.1%. The 5-year disease free survival (DFS) was 92.1% for all patients. The 10-year DFS was 89.9%.

The independent significant prognostic factors for a good outcome identified through the multivariate analysis were: age <75 years (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.001); tumour size ≤2[[ce:hsp sp="0.25"/]]cm (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.003); myometrial invasion ≤50% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.011); lymphadenectomy (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.02); EBI (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.001); and BT (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.031).

Toxicity occurred in 114 of the 162 patients who received radiotherapy (70.5%). The toxicity was mainly acute, and late in only 28.3% (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]45) of cases. The majority experienced G1-2 toxicity, and only 3% of patients experienced G3 late toxicity (5/162).

Conclusions

Our results suggest that age <75 years, tumour size ≤2[[ce:hsp sp="0.25"/]]cm, myometrial invasion ≤50%, lymphadenectomy, EBI, and BT, are predictors of a good outcome in EC.

Abstract

Aim

To evaluate the effect of lymphadenectomy and/or radiotherapy on recurrence and survival patterns in endometrial carcinoma (EC) in a radiotherapy reference centre population.

Material and Methods

A retrospective population-based review was conducted on 261 patients with stages I–III EC. Univariate and multivariate analyses were carried out. Both recurrence and survival were analysed according to patient age, FIGO stage, tumour size, myometrial invasion, tumour grade, lymphadenectomy, external beam irradiation (EBI), and brachytherapy (BT).

Results

Median age: 64.8 years. Median follow-up: 151 months. The following treatments were administered: surgery, 97.32%; lymph-node dissection, 54.4%; radiotherapy, 162 patients (62%) (EBI and BT: 64.1%, BT alone: 30.2%, EBI alone: 5.6%).

Twenty-six patients (9.96%) suffered loco-regional recurrence, whilst 27 (10.34%) suffered distant failure. The 5-year overall survival (OS) for all stages was 80.1%. The 5-year disease free survival (DFS) was 92.1% for all patients. The 10-year DFS was 89.9%.

The independent significant prognostic factors for a good outcome identified through the multivariate analysis were: age <75 years (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.001); tumour size ≤2[[ce:hsp sp="0.25"/]]cm (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.003); myometrial invasion ≤50% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.011); lymphadenectomy (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.02); EBI (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.001); and BT (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.031).

Toxicity occurred in 114 of the 162 patients who received radiotherapy (70.5%). The toxicity was mainly acute, and late in only 28.3% (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]45) of cases. The majority experienced G1-2 toxicity, and only 3% of patients experienced G3 late toxicity (5/162).

Conclusions

Our results suggest that age <75 years, tumour size ≤2[[ce:hsp sp="0.25"/]]cm, myometrial invasion ≤50%, lymphadenectomy, EBI, and BT, are predictors of a good outcome in EC.

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Keywords

Endometrial carcinoma; Prognostic factors; Radiotherapy; Lymphadenectomy

About this article
Title

The effect of lymphadenectomy and radiotherapy on recurrence and survival in endometrial carcinoma. Experience in a population reference centre

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 1 (2015)

Pages

50-56

Published online

2015-01-01

DOI

10.1016/j.rpor.2014.09.003

Bibliographic record

Rep Pract Oncol Radiother 2015;20(1):50-56.

Keywords

Endometrial carcinoma
Prognostic factors
Radiotherapy
Lymphadenectomy

Authors

Meritxell Arenas
Marina Gascón
Àngels Rovirosa
Víctor Hernández
Francesc Riu
Iolanda López
Angel Montero
Sebastià Sabater

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