Τίτλος:
SATEN III - Splitting Adjuvant Treatment of stage III ENdometrial cancers: An international, multicenter study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Kahramanoglu, I.
Meydanli, M.M.
Taranenka, S.
Ayhan, A.
Salman, C.
Sanci, M.
Demirkiran, F.
Ortac, F.
Haidopoulos, D.
Sukhin, V.
Kaidarova, D.
Stepanyan, A.
Farazaneh, F.
Aliyev, S.
Ulrikh, E.
Kurdiani, D.
Yalcin, I.
Mavrichev, S.
Akilli, H.
Sarl, M.E.
Pletnev, A.
Aslan, K.
Bese, T.
Kairbayev, M.
Vlachos, D.
Gultekin, M.
Περιοδικό:
International Journal of Gynecological Cancer
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
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
DOI:
10.1136/ijgc-2019-000643
