@article{3121925,
    title = "SATEN III - Splitting Adjuvant Treatment of stage III ENdometrial cancers: An international, multicenter study",
    author = "Kahramanoglu, I. and Meydanli, M.M. and Taranenka, S. and Ayhan, A. and Salman, C. and Sanci, M. and Demirkiran, F. and Ortac, F. and Haidopoulos, D. and Sukhin, V. and Kaidarova, D. and Stepanyan, A. and Farazaneh, F. and Aliyev, S. and Ulrikh, E. and Kurdiani, D. and Yalcin, I. and Mavrichev, S. and Akilli, H. and Sarl, M.E. and Pletnev, A. and Aslan, K. and Bese, T. and Kairbayev, M. and Vlachos, D. and Gultekin, M.",
    journal = "International Journal of Gynecological Cancer",
    year = "2019",
    volume = "29",
    number = "8",
    pages = "1271-1279",
    publisher = "BMJ Publishing Group",
    issn = "1048-891X, 1525-1438",
    doi = "10.1136/ijgc-2019-000643",
    keywords = "carboplatin;  paclitaxel, adjuvant chemoradiotherapy;  adult;  Article;  ascites fluid cytology;  cancer adjuvant therapy;  cancer combination chemotherapy;  cancer prognosis;  cancer radiotherapy;  cancer staging;  cancer surgery;  disease free survival;  endometrium cancer;  female;  follow up;  human;  lymph node dissection;  major clinical study;  multicenter study;  multimodality cancer therapy;  overall survival;  pelvis lymph node;  priority journal;  retrospective study;  adjuvant chemotherapy;  adjuvant radiotherapy;  clinical trial;  endometrium tumor;  Kaplan Meier method;  middle aged;  mortality;  multivariate analysis;  pathology;  prognosis;  statistical model;  survival rate, Chemoradiotherapy, Adjuvant;  Chemotherapy, Adjuvant;  Disease-Free Survival;  Endometrial Neoplasms;  Female;  Humans;  Kaplan-Meier Estimate;  Logistic Models;  Middle Aged;  Multivariate Analysis;  Neoplasm Staging;  Prognosis;  Radiotherapy, Adjuvant;  Retrospective Studies;  Survival Rate",
    abstract = "Introduction: The purposes of this study were to compare adjuvant treatment modalities and to determine prognostic factors in stage III endometrioid endometrial cancer (EC). Methods: SATEN III was a retrospective study involving 13 centers from 10 countries. Patients who had been operated on between 1998 and 2018 and diagnosed with stage III endometrioid EC were analyzed. Results: A total of 990 women were identified; 317 with stage IIIA, 18 with stage IIIB, and 655 with stage IIIC diseases. The median follow-up was 42 months. The 5-year disease-free survival (DFS) of patients with stage III EC by adjuvant treatment modality was 68.5% for radiotherapy (RT), 54.6% for chemotherapy (CT), and 69.4% for chemoradiation (CRT) (p=0.11). The 5-year overall survival (OS) for those patients was 75.6% for RT, 75% for CT, and 80.7% for CRT (p=0.48). For patients with stage IIIA disease treated by RT versus CT versus CRT, the 5-year OS rates were 75.6%, 75.0%, and 80.7%, respectively (p=0.48). Negative peritoneal cytology (HR: 0.45, 95% CI: 0.23 to 0.86; p=0.02) and performance of lymphadenectomy (HR: 0.33, 95% CI: 0.16 to 0.77, p=0.001) were independent predictors for improved OS for stage IIIA EC. For women with stage IIIC EC treated by RT, CT, and CRT, the 5-year OS rates were 78.9%, 67.0%, and 69.8%, respectively (p=0.08). Independent prognostic factors for better OS for stage IIIC disease were age <60 (HR: 0.50, 95%CI: 0.36 to 0.69, p<0.001), grade 1 or 2 disease (HR: 0.59, 95% CI: 0.37 to 0.94, p=0.014; and HR: 0.65, 95%CI: 0.46 to 0.91, p=0.014, respectively), absence of cervical stromal involvement (HR: 063, 95% CI: 0.46 to 0.86, p=0.004) and performance of para-aortic lymphadenectomy (HR: 0.52, 95% CI: 0.35 to 0.72, p<0.001). Discussion: Although not statistically significant, CRT seemed to be a better adjuvant treatment option for stage IIIA endometrioid EC. Systematic lymphadenectomy seemed to improve survival outcomes in stage III endometrioid EC. © 2019 IGCS and ESGO."
}