Introduction: The efficacy of postoperative radiotherapy (RT) in the treatment of earlystage endometrial carcinoma (EC) is still under debate. This study was aimed to review the outcome and adverse effects in patients treated for EC with postoperative RT at a single center. Methods: A total of 883 patients with pathological stages I to II EC were retrospectively analyzed. Surgery consisted of total abdominal hysterectomy and bilateral salpingooophorectomy, or vaginal hysteroannessiectomy in 532 patients (60.2%) with pelvic lymphadenectomy in 351 patients (39.8%). Seven hundred forty-seven patients (84.6%) underwent whole pelvic RT (WPRT) and 136 (15.4%) combined WPRT and vaginal brachytherapy (BT) boost. Results: At a median follow-up of 9 years (range, 1.2Y27.6 years), we observed 10.6% disease relapse. Forty-seven patients experienced local recurrence (LR), and 38 patients experienced distant metastases (DMs). At univariate analysis, age at diagnosis (P G 0.0001), stage (P G 0.04), and histological subtype (P G 0.0001) resulted in significant prognostic factors. At multivariate analysis, histotype emerged as an independent relapse predictor (P = 0.0001). Acute WPRT-related toxicity was mild; diarrhea was the most common adverse effect (19.8%). We recorded long-term adverse effects in 7.8% of the patients. Conclusions: Our study showed that patients with early-stage EC have a good outcome in overall survival and disease-free survival. In our experience, standard surgery (including hysterectomy and bilateral salpingo-oophorectomy followed by WPRTwith or without BT) showed an acceptable toxicity profile.

Postoperative radiotherapyin stage I/II endometrial cancer: retrospective analysis of 883 patients treated at the University of Florence / Scotti, V; Borghesi, S; Meattini, I; Saieva, C; Rossi, F; Petrucci, A; Galardi, A; Livi, L; Agresti, B; Fambrini, M; Marchionni, M; Biti, G.. - In: INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. - ISSN 1048-891X. - STAMPA. - 20:(2010), pp. 1540-1548. [10.1111/IGC.0b013e3181f8fa26]

Postoperative radiotherapyin stage I/II endometrial cancer: retrospective analysis of 883 patients treated at the University of Florence.

SCOTTI, VIERI;MEATTINI, ICRO;BITI, GIAMPAOLO;LIVI, LORENZO;FAMBRINI, MASSIMILIANO;MARCHIONNI, MAURO;
2010

Abstract

Introduction: The efficacy of postoperative radiotherapy (RT) in the treatment of earlystage endometrial carcinoma (EC) is still under debate. This study was aimed to review the outcome and adverse effects in patients treated for EC with postoperative RT at a single center. Methods: A total of 883 patients with pathological stages I to II EC were retrospectively analyzed. Surgery consisted of total abdominal hysterectomy and bilateral salpingooophorectomy, or vaginal hysteroannessiectomy in 532 patients (60.2%) with pelvic lymphadenectomy in 351 patients (39.8%). Seven hundred forty-seven patients (84.6%) underwent whole pelvic RT (WPRT) and 136 (15.4%) combined WPRT and vaginal brachytherapy (BT) boost. Results: At a median follow-up of 9 years (range, 1.2Y27.6 years), we observed 10.6% disease relapse. Forty-seven patients experienced local recurrence (LR), and 38 patients experienced distant metastases (DMs). At univariate analysis, age at diagnosis (P G 0.0001), stage (P G 0.04), and histological subtype (P G 0.0001) resulted in significant prognostic factors. At multivariate analysis, histotype emerged as an independent relapse predictor (P = 0.0001). Acute WPRT-related toxicity was mild; diarrhea was the most common adverse effect (19.8%). We recorded long-term adverse effects in 7.8% of the patients. Conclusions: Our study showed that patients with early-stage EC have a good outcome in overall survival and disease-free survival. In our experience, standard surgery (including hysterectomy and bilateral salpingo-oophorectomy followed by WPRTwith or without BT) showed an acceptable toxicity profile.
2010
20
1540
1548
Scotti, V; Borghesi, S; Meattini, I; Saieva, C; Rossi, F; Petrucci, A; Galardi, A; Livi, L; Agresti, B; Fambrini, M; Marchionni, M; Biti, G.
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/593597
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