The impact of adjuvant therapies on survival for women with state II endometrial carcinoma

Document Type

Conference Proceeding

Publication Date


Publication Title

Int J Radiat Oncol Biol Phys


Objectives: To report survival outcomes in women with stage II uterine non-endometrioid carcinoma (NEC) after surgical staging with various adjuvant management options using the National Cancer Database (NCDB).

Methods: The NCDB was queried for women with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage II uterine NEC diagnosed from 2004 to 2012 who underwent hysterectomy followed by adjuvant management [active surveillance, radiation treatment (RT) or chemotherapy (CT)]. Chi-squared tests were performed to compare differences in outcome by type of adjuvant management. Overall survival (OS) was assessed by Kaplan-Meier and log-rank tests. Univariate and multivariate analyses were performed to identify statistically significant predictors of OS.

Results: We identified 1238 women who met our inclusion criteria. The median follow-up time was 51.5 months. Simple hysterectomy was performed in 1009 women (82%) with lymph node dissection performed in 1004 women (81%). Median number of dissected lymph nodes was 13. 35% of patients were diagnosed with carcinosarcoma. Adjuvant RT was used in 49% of patients and CT in 45%. On multivariate analysis of OS, old age, African-American race, no or fewer number of examined LNs, carcinosarcoma and not receiving any adjuvant therapies were independent predictors of worse OS. For those patients who received adjuvant RT with CT, administering CT first was associated with a better 5-year OS compared to those who received RT first (PZ0.02). The 5-year OS for the entire cohort was 65%.

Conclusions: In this nationwide hospital-based study of women with FIGO stage II uterine non-endometrioid carcinoma, adjuvant radiation and chemotherapy improved overall survival. The sequence of administering chemotherapy before radiation treatment was associated with a better overall survival.




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