바로가기  >

Abstract

OBJECTIVE:

To investigate whether combined chemoradiotherapy (CTRT) confers a benefit for survival outcome over radiotherapy (RT) alone after primary surgery in patients with FIGO stage IIIC endometrial adenocarcinoma.

METHODS:

We conducted a multicenter retrospective study of patients with surgical stage IIIC endometrial cancer from 1990 to 2011. Adjuvant RT alone was performed in 85 patients (40.3%) and adjuvant CTRT in 126 patients (59.7%). Disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier method and Cox proportional hazards model.

RESULTS:

Stage IIIC1 and stage IIIC2 accounted for 63% and 37%, respectively. FIGO IIIC2 had a higher recurrence rate than FIGO IIIC1 (38.5% vs. 29.3%, p=0.172). Five-year OS and DFS were lower in FIGO IIIC2 than FIGO IIIC1 (85.1% vs. 76.9%, p=0.417; 71.0% vs. 59.2%, p=0.108, respectively). Eighteen patients (13.5%) in stage IIIC1 developed PALN recurrence, whereas only one (3.3%) in stage IIIC2 had PALN recurrence (p=0.001). In multivariate analysis, predictors of DFS were parametrial invasion (HR, 3.49; 95% CI, 1.83-6.64; p<0.001), higher grade (HR, 2.78; 95% CI, 1.31-5.89; p=0.008), and >3 positive pelvic nodes (HR, 1.84; 95% CI, 1.11-3.05; p=0.019). Combined CTRT did not affect DFS or OS in IIIC1 and IIIC2 compared with RT alone.

CONCLUSION:

CTRT showed comparable survival outcome to RT alone. Half of relapses (46%) in stage IIIC1 occurred in PALN region, whereas relapse in stage IIIC2 primarily occurred in distant metastasis (90%). Future randomized studies are needed to determine which subgroup may be most likely to benefit from CCRT. 

​

Author information

Yoon MS1, Park W2, Huh SJ3, Kim HJ4, Kim YS5, Kim YB6, Kim JY7, Lee JH8, Kim HJ9, Cha J10, Kim JH11, Kim J12, Yoon WS13, Choi JH14, Chun M15, Choi Y16, Chang SK17, Lee KK18, Kim M19. 

1Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do, Republic of Korea.

2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: wonro.park@samsung.com.

3Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

4Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.

5Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea.

6Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.

7Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.

8Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, Suwon, Republic of Korea.

9Department of Radiation Oncology, Inha University School of Medicine, Incheon, Republic of Korea.

10Department of Radiation Oncology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

11Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.

12Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul, Republic of Korea.

13Department of Radiation Oncology, Korea University College of Medicine, Seoul, Republic of Korea.

14Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Republic of Korea.

15Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.

16Department of Radiation Oncology, Dong-A University School of Medicine, Busan, Republic of Korea.

17Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.

18Department of Radiation Oncology, University of Wonkwang School of Medicine, Iksan, Republic of Korea.

19Department of Radiation Oncology, Incheon St. Marys Hospital, The Catholic University of Korea, Incheon, Republic of Korea.