A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma

A Korean Radiation Oncology Group study (KROG 13-17)

Mee Sun Yoon, Won Park, Seung Jae Huh, Hak Jae Kim, Young Seok Kim, Yongbae Kim, Joo Young Kim, Jong Hoon Lee, Hun Jung Kim, Jihye Cha, Jin Hee Kim, Juree Kim, Won Sup Yoon, Jin Hwa Choi, Mison Chun, Youngmin Choi, Sei Kyung Chang, Kang Kyoo Lee, Myungsoo Kim

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)519-525
Number of pages7
JournalGynecologic Oncology
Volume138
Issue number3
DOIs
Publication statusPublished - 2015 Sep 1

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Radiation Oncology
Adenocarcinoma
Disease-Free Survival
Recurrence
Survival
Radiotherapy
Therapeutics
Adjuvant Radiotherapy
Chemoradiotherapy
Endometrial Neoplasms
Proportional Hazards Models
Multicenter Studies
Multivariate Analysis
Retrospective Studies
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Yoon, Mee Sun ; Park, Won ; Huh, Seung Jae ; Kim, Hak Jae ; Kim, Young Seok ; Kim, Yongbae ; Kim, Joo Young ; Lee, Jong Hoon ; Kim, Hun Jung ; Cha, Jihye ; Kim, Jin Hee ; Kim, Juree ; Yoon, Won Sup ; Choi, Jin Hwa ; Chun, Mison ; Choi, Youngmin ; Chang, Sei Kyung ; Lee, Kang Kyoo ; Kim, Myungsoo. / A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma : A Korean Radiation Oncology Group study (KROG 13-17). In: Gynecologic Oncology. 2015 ; Vol. 138, No. 3. pp. 519-525.
@article{6b855eee5af1495ca39a26add27e6e50,
title = "A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma: A Korean Radiation Oncology Group study (KROG 13-17)",
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 = "Yoon, {Mee Sun} and Won Park and Huh, {Seung Jae} and Kim, {Hak Jae} and Kim, {Young Seok} and Yongbae Kim and Kim, {Joo Young} and Lee, {Jong Hoon} and Kim, {Hun Jung} and Jihye Cha and Kim, {Jin Hee} and Juree Kim and Yoon, {Won Sup} and Choi, {Jin Hwa} and Mison Chun and Youngmin Choi and Chang, {Sei Kyung} and Lee, {Kang Kyoo} and Myungsoo Kim",
year = "2015",
month = "9",
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doi = "10.1016/j.ygyno.2015.06.030",
language = "English",
volume = "138",
pages = "519--525",
journal = "Gynecologic Oncology",
issn = "0090-8258",
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Yoon, MS, Park, W, Huh, SJ, Kim, HJ, Kim, YS, Kim, Y, Kim, JY, Lee, JH, Kim, HJ, Cha, J, Kim, JH, Kim, J, Yoon, WS, Choi, JH, Chun, M, Choi, Y, Chang, SK, Lee, KK & Kim, M 2015, 'A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma: A Korean Radiation Oncology Group study (KROG 13-17)', Gynecologic Oncology, vol. 138, no. 3, pp. 519-525. https://doi.org/10.1016/j.ygyno.2015.06.030

A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma : A Korean Radiation Oncology Group study (KROG 13-17). / Yoon, Mee Sun; Park, Won; Huh, Seung Jae; Kim, Hak Jae; Kim, Young Seok; Kim, Yongbae; Kim, Joo Young; Lee, Jong Hoon; Kim, Hun Jung; Cha, Jihye; Kim, Jin Hee; Kim, Juree; Yoon, Won Sup; Choi, Jin Hwa; Chun, Mison; Choi, Youngmin; Chang, Sei Kyung; Lee, Kang Kyoo; Kim, Myungsoo.

In: Gynecologic Oncology, Vol. 138, No. 3, 01.09.2015, p. 519-525.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma

T2 - A Korean Radiation Oncology Group study (KROG 13-17)

AU - Yoon, Mee Sun

AU - Park, Won

AU - Huh, Seung Jae

AU - Kim, Hak Jae

AU - Kim, Young Seok

AU - Kim, Yongbae

AU - Kim, Joo Young

AU - Lee, Jong Hoon

AU - Kim, Hun Jung

AU - Cha, Jihye

AU - Kim, Jin Hee

AU - Kim, Juree

AU - Yoon, Won Sup

AU - Choi, Jin Hwa

AU - Chun, Mison

AU - Choi, Youngmin

AU - Chang, Sei Kyung

AU - Lee, Kang Kyoo

AU - Kim, Myungsoo

PY - 2015/9/1

Y1 - 2015/9/1

N2 - 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.

AB - 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.

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