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Abstract
OBJECTIVE:
To compare the survival outcomes of adjuvant radiotherapy and chemotherapy in women with uterine-confined endometrial cancer with uterine papillary serous carcinoma (UPSC) or clear cell carcinoma (CCC).

METHODS:
Medical records of 80 women who underwent surgical staging for endometrial cancer were retrospectively reviewed. Stage I UPSC and CCC were pathologically confirmed after surgery. Survival outcomes were compared between the adjuvant radiotherapy and chemotherapy groups.

RESULTS:
Fifty-four (67.5%) and 26 (32.5%) women had UPSC and CCC, respectively. Adjuvant therapy was administered to 59/80 (73.8%) women (25 radiotherapy and 34 chemotherapy). High preoperative serum cancer antigen-125 level (25.1±20.2 vs. 11.5±6.5 IU/mL, p<0.001), open surgery (71.2% vs. 28.6%, p=0.001), myometrial invasion (MI) ≥1/2 (33.9% vs. 0, p=0.002), and lymphovascular space invasion (LVSI; 28.8% vs. 4.8%, p=0.023) were frequent in women who received adjuvant therapy compared to those who did not. However, the histologic type, MI ≥1/2, and LVSI did not differ between women who received adjuvant radiotherapy and those who received chemotherapy. The 5-year progression-free survival (78.9% vs. 80.1%, p>0.999) and overall survival (77.5% vs. 87.8%, p=0.373) rates were similar between the groups. Neither radiotherapy (hazard ratio [HR]=1.810; 95% confidence interval [CI]=0.297-11.027; p=0.520) nor chemotherapy (HR=1.638; 95% CI=0.288-9.321; p=0.578) after surgery was independently associated with disease recurrence.

CONCLUSION:
Our findings showed similar survival outcomes for adjuvant radiotherapy and chemotherapy in stage I UPSC and CCC of the endometrium. Further large study with analysis stratified by MI or LVSI is required.

Author information

Kim M1, Kwon BS2, Chang HK3, Lee S4, Chang SJ5, Choi JY6, Park SY3, Lee M7, Ryu HS5, Kim YB8.
1
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea.
2
Department of Obstetrics and Gynecology, Pusan National University Hospital, Busan, Korea.
3
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
4
Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Korea.
5
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
6
Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Korea.
7
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
8
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ybkimlh@snubh.org.