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Management of high-grade stage I adenocarcinoma of the endometrium: hysterectomy following low dose external beam pelvic irradiation.

Abstract：

:Sixty-eight patients with FIGO stage I, grade 2 or 3 adenocarcinoma of the endometrium were treated according to a protocol involving 10 Gy external pelvic irradiation, prompt hysterectomy with surgical staging, and postoperative therapy individualized according to surgical-pathologic findings. Five-year survival for the entire group was 78%, 87% for those with grade 2 disease, and 59% for those with grade 3 disease. For patients whose disease was found to be confined to the uterus, surgical stage I, the 5-year survival was 98%. Patients with surgical stage I, grades 2 and 3 disease had 97 and 100% probabilities of surviving 5 years, respectively. Five-year disease-free probability was 96% for all patients with surgical stage I carcinoma, 97% for patients with grade 2 disease, and 94% for patients with grade 3 disease. Myometrial penetration influenced survival; no patient with less than 50% myometrial penetration died or suffered a relapse, while only 40% of patients with deeper penetration survived 5 years. Twenty-three percent of patients with surgically confirmed disease spread beyond the corpus survived 5 years; 29% remained disease-free at this interval. Ten of the 68 patients developed recurrences, none has had a known pelvic recurrence. Two major complications, one requiring surgery, were seen, both in patients receiving postoperative external beam irradiation. The rationale behind low-dose, preoperative external pelvic irradiation is described, and an approach to high-grade, FIGO stage I adenocarcinoma of the endometrium is outlined.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Shimm DS,Wang CC,Fuller AF Jr,Nelson JH Jr,Nikrui N,Young RH,Scully RE

doi

10.1016/0090-8258(86)90222-2

subject

Has Abstract

pub_date

1986-02-01 00:00:00

pages

183-91

issue

2

eissn

0090-8258

issn

1095-6859

journal_volume

23

pub_type

杂志文章

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