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17 April 2019 : Clinical Research  

The Effect of Prognostic Factors and Adjuvant Radiotherapy on Survival in Patients with High-Grade Early-Stage Endometrial Cancer: A Retrospective Clinical Study

Ercan Yilmaz1A*, Simay Gurocak2B, Rauf Melekoglu1F, Isil Koleli1D, Simge Faydali1C, Oztun Temelli2E, Tuba Yar3B

DOI: 10.12659/MSM.913740

Med Sci Monit 2019; 25:2811-2818

Abstract

BACKGROUND: This retrospective clinical study aimed to investigate the effect of prognostic factors and adjuvant radiotherapy in patients with high-grade early-stage endometrial cancer on overall survival (OS) and disease-free survival (DFS).

MATERIAL AND METHODS: The medical records of patients diagnosed with high-grade, early stage (I or II) endometrial adenocarcinoma who had received adjuvant radiotherapy after surgery were reviewed.

RESULTS: Seventy-nine patients included 39 patients (49.4%) with stage II endometrial cancer, 25 patients (31.6%) with histologic grade 3 tumors, and 47 patients (59.5%) with endometrial cancer showing lymphovascular space invasion (LVSI). There were 45 patients (57.0%) who received external pelvic radiotherapy with an average dose of 46.0 Gy (range, 11.2–50.4 Gy), and 34 patients (43.0%) received vaginal brachytherapy (VBT) with an average dose of 21.5 Gy (range, 10–36 Gy). Multivariate analysis showed that tumor stage (HR, 4.066; 95% CI, 1.227–13.467; p=0.022) and histologic grade (HR, 16.652; 95% CI, 4.430–62.589; p<0.001) were independent predictors for OS. Increased serum CA-125 levels (HR, 1.136; 95% CI, 0.995–1.653; p=0.047) and histologic grade (HR, 3.236; 95% CI, 1.107–15.156; p=0.015) were independent predictors for DFS. Adjuvant radiotherapy was not found to be significantly associated with improved OS (HR, 1.259; 95% CI, 0.518–3.058; p=0.612) or DFS (HR, 1.056; 95% CI, 0.994–1.123; p=0.078).

CONCLUSIONS: This retrospective study showed that in high-grade early-stage endometrial cancer treated with postoperative adjuvant radiotherapy, independent predictors for OS were tumor stage and grade. Adjuvant radiotherapy was not associated with improved OS or DFS.

Keywords: Endometrial Neoplasms, Prognosis, Survival, Aged, Aged, 80 and over, Brachytherapy, Disease-Free Survival, Endometrium, Middle Aged, Neoplasm Grading, Neoplasm Staging, Radiotherapy, Adjuvant, Retrospective Studies, Survival Analysis, Treatment Outcome

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750