Defining the survival benefit of adjuvant pelvic radiotherapy and chemotherapy versus chemotherapy alone in stages III-IVA endometrial carcinoma.

Abstract:

OBJECTIVES:To determine which patients with locoregionally advanced endometrial cancer may benefit from pelvic external beam radiotherapy (EBRT) in addition to chemotherapy compared to chemotherapy alone. METHODS:Patients with FIGO stages III-IVA endometrial carcinoma between 2004 and 2016 who underwent at least total hysterectomy and adjuvant multiagent chemotherapy were identified in the National Cancer Database. The primary outcome was overall survival according to receipt of pelvic EBRT, analyzed using the Kaplan-Meier method and Cox multivariable regression. RESULTS:In total, 13,270 patients were identified (62% pure endometrioid, 38% serous/clear cell or mixed histology; 22.6% stage IIIA, 4.7% stage IIIB, 71.2% stage IIIC, 1.5% stage IVA), of whom 40% received pelvic EBRT. In univariable analysis, EBRT was associated with absolute 5-year survival increases of 5% and 9% in the endometrioid and non-endometrioid cohorts, respectively (P < 0.0001). In multivariable analyses stratified by stage and histology, patients with a significant benefit from EBRT were stage IIIC (specifically IIIC2) endometrioid (adjusted hazard ratio [HR] 0.73, P = 0.01) and stages IIIB and IIIC non-endometrioid (adjusted HR 0.52, P = 0.01 and adjusted HR 0.79, P < 0.0001). The benefit of EBRT in node-positive patients persisted in those who underwent more extensive lymphadenectomy. CONCLUSIONS:Stages III-IVA endometrial cancer comprised a heterogeneous population with respect to the added benefit of radiotherapy compared to chemotherapy alone. Patients with stage IIIC2 endometrioid and stages IIIB-C non-endometrioid cancer may be most likely to benefit from pelvic EBRT.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Xiang M,English DP,Kidd EA

doi

10.1016/j.ygyno.2019.06.020

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

487-494

issue

3

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(19)31336-8

journal_volume

154

pub_type

杂志文章
  • Normal pregnancy and delivery following conservative surgery and chemotherapy for ovarian endodermal sinus tumor.

    abstract::Management of younger patients with early stage ovarian endodermal sinus tumor who desire to have children can be a challenging problem. However, after an adequate and thorough staging procedure for the patient's tumor status, a Stage Iai endodermal sinus tumor may be treated with conservative surgery only, followed b...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(84)90184-7

    authors: Bakri YN,Given FT Jr

    更新日期:1984-10-01 00:00:00

  • The haplotype of two FSHR polymorphisms in ovarian cancer--a potential role of ethnology in risk modification.

    abstract:OBJECTIVES:The precise role of gonadotropins in the carcinogenesis of epithelial ovarian cancer remains uncertain. Recently, the haplotype of two single nucleotide polymorphisms, Thr307Ala (rs6165) and Asn680Ser (rs6166), has been described as a risk factor for ovarian cancer in Chinese women. In this study we investig...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2008.12.011

    authors: Heubner M,Riemann K,Otterbach F,Kimmig R,Kasimir-Bauer S,Siffert W,Wimberger P

    更新日期:2009-03-01 00:00:00

  • Accuracy of diffusion-weighted echo-planar MR imaging and ADC mapping in the evaluation of residual cervical carcinoma after radiation therapy.

    abstract:OBJECTIVES:The impact of diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADCs) of MR imaging on the evaluation of residual Uterine Cervical Carcinoma after Radiation Therapy, in addition to conventional MR images. METHODS:Fourty-nine women presenting with a uterine cervical cancer were examined w...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2011.06.009

    authors: Levy A,Caramella C,Chargari C,Medjhoul A,Rey A,Zareski E,Boulet B,Bidault F,Dromain C,Balleyguier C

    更新日期:2011-10-01 00:00:00

  • Sexual function following hysterectomy for endometrial cancer: A five-year follow up investigation.

    abstract:OBJECTIVES:We sought to determine a baseline and five-year follow up sexual function score in women undergoing hysterectomy for endometrial cancer. METHODS:A cross-section of endometrial cancer patients receiving care from 2006 to 2010 was identified. Patients were surveyed during academic year 2011 using the Pelvic O...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2018.10.025

    authors: Buckingham L,Haggerty A,Graul A,Morgan M,Burger R,Ko E,Andy U,Giuntoli R

    更新日期:2019-01-01 00:00:00

  • Hepatic resection for metastatic gynecologic carcinomas.

    abstract:OBJECTIVE:To report a series of cases of hepatic resection for metastatic gynecologic carcinomas. METHODS:We reviewed the records of all patients who underwent hepatic resection for metachronous liver metastases from gynecologic carcinomas at our institution from 1986 to 1996. RESULTS:Twelve patients were identified ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1006/gyno.1997.4727

    authors: Chi DS,Fong Y,Venkatraman ES,Barakat RR

    更新日期:1997-07-01 00:00:00

  • Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy.

    abstract:OBJECTIVES:To clarify the anatomy necessary for the nerve sparing Okabayashi's radical hysterectomy, we meticulously separated the blood vessels and connective tissues to preserve the pelvic splanchnic nerve, the hypogastric nerve, and the bladder branch of the inferior hypogastric plexus under magnification (x2.5) dur...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2007.08.076

    authors: Fujii S,Takakura K,Matsumura N,Higuchi T,Yura S,Mandai M,Baba T,Yoshioka S

    更新日期:2007-10-01 00:00:00

  • Trimetrexate in the treatment of recurrent or advanced leiomyosarcoma of the uterus: a phase II study of the Gynecologic Oncology Group.

    abstract:OBJECTIVE:This study was conducted to determine the objective response of trimetrexate in patients with advanced or recurrent leiomyosarcoma of the uterus. METHODS:Eligibility was restricted to patients with measurable disease who had received no more than one prior chemotherapy regimen, who had adequate bone marrow, ...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1006/gyno.2001.6482

    authors: Smith HO,Blessing JA,Vaccarello L

    更新日期:2002-01-01 00:00:00

  • Loop electrocautery excisional procedure: therapeutic effectiveness as an ablation and a conization equivalent.

    abstract::This study was designed to compare the effectiveness of loop excision procedures as ablation and conization equivalents, and their use in recurrent cervical high-grade dysplasia patients. We retrospectively reviewed patients undergoing loop procedures between January 1992 and April 1994. Conization equivalents were de...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.1996.0132

    authors: Gold M,Dunton CJ,Murray J,Macones G,Hanau C,Carlson JA Jr

    更新日期:1996-05-01 00:00:00

  • Implementation of a standardized voiding management protocol to reduce unnecessary re-catheterization - A quality improvement project.

    abstract:OBJECTIVE:To design and implement a standardized postoperative voiding management protocol that accurately identifies patients with urinary retention and reduces unnecessary re-catheterization. METHODS:A postoperative voiding management protocol was designed and implemented in patients undergoing major, inpatient, non...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2020.01.036

    authors: Brackmann M,Carballo E,Uppal S,Torski J,Reynolds RK,McLean K

    更新日期:2020-05-01 00:00:00

  • Implicit bias toward cervical cancer: Provider and training differences.

    abstract:OBJECTIVE:Implicit prejudice and stereotyping may exist in health care providers automatically without their awareness. These biases can correlate with outcomes that are consequential for the patient. This study examined gynecologic oncology care providers' implicit prejudice and stereotyping toward cervical cancer. M...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2019.01.013

    authors: Liang J,Wolsiefer K,Zestcott CA,Chase D,Stone J

    更新日期:2019-04-01 00:00:00

  • Human cervical cells immortalized in vitro with oncogenic human papillomavirus DNA differentiate dysplastically in vivo.

    abstract::Human papillomavirus (HPV) types 16 and 18 are associated with cervical dysplasia and carcinoma. In vitro integration of HPV-16 or HPV-18 DNA into cultured human cervical cells results in their immortalization. In this study, in vivo differentiation of human cervical cells immortalized with recombinant HPV-16 or HPV-1...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(90)90082-v

    authors: Waggoner SE,Woodworth CD,Stoler MH,Barnes WA,Delgado G,DiPaolo JA

    更新日期:1990-09-01 00:00:00

  • Endometrial stromal sarcoma: objective response to letrozole.

    abstract:BACKGROUND:Low-grade endometrial stromal sarcoma is generally an indolent tumor rich in estrogen and progesterone receptors. Objective responses to hormonal therapy, most commonly with megestrol acetate, have been reported. CASE:The patient is a 51-year-old woman who presented with low-grade endometrial stromal sarcom...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.2001.6238

    authors: Maluf FC,Sabbatini P,Schwartz L,Xia J,Aghajanian C

    更新日期:2001-08-01 00:00:00

  • The performance of Dynamic Spectral Imaging colposcopy depends on indication for referrals.

    abstract::OBJECTIVE. A previous study has shown that Dynamic Spectral Imaging (DSI) colposcopy increases the sensitivity of the colposcopic examination in women referred with abnormal cytology. In this study we have reanalyzed the performance of DSI and conventional colposcopy for new referral conditions and for low-grade cytol...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1016/j.ygyno.2015.10.009

    authors: Louwers JA,Zaal A,Kocken M,Berkhof J,Papagiannakis E,Snijders PJ,Meijer CJ,Verheijen RH

    更新日期:2015-12-01 00:00:00

  • Comprehensive genomic profiling reveals inactivating SMARCA4 mutations and low tumor mutational burden in small cell carcinoma of the ovary, hypercalcemic-type.

    abstract:OBJECTIVE:Small cell carcinoma of the ovary, hypercalcemic-type (SCCOHT) is a rare, extremely aggressive neoplasm that usually occurs in young women and is characterized by deleterious germline or somatic SMARCA4 mutations. We performed comprehensive genomic profiling (CGP) to potentially identify additional clinically...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2017.09.031

    authors: Lin DI,Chudnovsky Y,Duggan B,Zajchowski D,Greenbowe J,Ross JS,Gay LM,Ali SM,Elvin JA

    更新日期:2017-12-01 00:00:00

  • Alterations in SPARC and VEGF immunoreactivity in epithelial ovarian cancer.

    abstract:OBJECTIVE:Secreted protein, acidic and rich in cysteine (SPARC), is a matricellular protein that modulates cell adhesion and growth. It is thought to play a decisive role in tissue remodeling and angiogenesis. Alterations in SPARC expression have been observed in a variety of solid tumors; however, no consistent patter...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.2000.5894

    authors: Paley PJ,Goff BA,Gown AM,Greer BE,Sage EH

    更新日期:2000-09-01 00:00:00

  • The opioid growth factor (OGF) and low dose naltrexone (LDN) suppress human ovarian cancer progression in mice.

    abstract:OBJECTIVE:The opioid growth factor (OGF) and its receptor, OGFr, serve as a tonically active inhibitory axis regulating cell proliferation in normal cells and a variety of cancers, including human ovarian cancer. Blockade of OGF and OGFr with the nonselective opioid receptor antagonist naltrexone (NTX) upregulates expr...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2011.04.009

    authors: Donahue RN,McLaughlin PJ,Zagon IS

    更新日期:2011-08-01 00:00:00

  • When will I feel normal again? Trajectories and predictors of persistent symptoms and poor wellbeing after primary chemotherapy for ovarian cancer.

    abstract:OBJECTIVES:After treatment for ovarian cancer, women want to know when they will feel 'normal' again. Our objective was to document the proportions of women with high levels of physical and emotional symptoms at the end of treatment, determine if/when they return to normal and identify groups at risk of persistent symp...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2020.07.029

    authors: Beesley VL,Webber K,Nagle CM,DeFazio A,Obermair A,Williams M,Friedlander M,Webb PM,OPAL Study Group.

    更新日期:2020-10-01 00:00:00

  • Sclerosing stromal tumor and bilateral teratomas: an unusual association.

    abstract::Sclerosing stromal tumor is an uncommon ovarian neoplasm that has only recently been defined and distinguished from fibrothecoma. This case report describes a 17-year-old patient who presented with a large sclerosing stromal tumor and a smaller mature teratoma in the left ovary. Eighteen months later, an immature tera...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(85)90261-6

    authors: Valente PT,Carr RF,Hanjani P

    更新日期:1985-06-01 00:00:00

  • Neuroendocrine (Merkel cell) carcinoma of the vulva: a case report and review of the literature.

    abstract::The clinical and pathologic features of a vulvar neuroendocrine (Merkel cell) neoplasm are presented. Cytologic studies of material obtained from needle aspiration suggested that the tumor was a small cell neoplasm possibly of neuroendocrine derivation. The light-microscopic findings of sheets of small, uniform cells ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(85)90053-8

    authors: Copeland LJ,Cleary K,Sneige N,Edwards CL

    更新日期:1985-11-01 00:00:00

  • Nomograms to predict isolated loco-regional or distant recurrence among women with uterine cancer.

    abstract:OBJECTIVE:While there is ample literature on prognostic factors for uterine cancer, currently there are nomeans to estimate an individual's risk for recurrence or to differentiate the risk of loco-regional recurrence from distant recurrence. We addressed this gap by developing nomograms to individualize the risk of rec...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2012.02.022

    authors: Kondalsamy-Chennakesavan S,Yu C,Kattan MW,Leung Y,Sykes P,Nascimento M,Nicklin J,Perrin L,Crandon A,Chetty N,Land R,Garrett A,Obermair A

    更新日期:2012-06-01 00:00:00

  • Radiotherapy with concurrent cisplatin-based doublet or weekly cisplatin for cervical cancer: a systematic review and meta-analysis.

    abstract:BACKGROUND:Treatment with weekly cisplatin (CDDP) plus radiotherapy (RT) is the standard regimen for stage IB to stage IVA cervical carcinoma (CC). We performed a systematic review and meta-analysis of published studies to evaluate whether CDDP-based doublet therapy improves survival compared to weekly CDDP plus RT in ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.ygyno.2014.04.049

    authors: Petrelli F,De Stefani A,Raspagliesi F,Lorusso D,Barni S

    更新日期:2014-07-01 00:00:00

  • Gynecologic oncology providers endorse practice-changing impact of communication skills training.

    abstract:OBJECTIVE:Effective communication improves patient outcomes and is crucial to good patient care. Communication skills training (CST) has been shown to improve communication skills in non-gynecologic oncology specialties. We sought to develop and test CST for gynecologic oncology (GO) providers. METHODS:We developed an...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2019.03.242

    authors: Lefkowits C,Bevis K,Carey EC,Sheeder J,Arnold RM,Podgurski L

    更新日期:2019-06-01 00:00:00

  • A follow-up study of patients with cervical cancer after resection, with special emphasis on the incidence of second primary cancers.

    abstract::The causes of death in long-term survivors after resection of cervical cancer were investigated in a follow-up study of 375 women, focusing especially on the postoperative development of second primary cancers. The 5- and 10-year overall survival rates were 75.0 and 66.0%, respectively, in cases that showed frank inva...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.1995.1011

    authors: Tominaga K,Koyama Y,Sasagawa M,Obata N,Kamata H,Yamaguchi E,Nagai M

    更新日期:1995-01-01 00:00:00

  • A need for laparoscopic evaluation of patients with endometrial carcinoma selected for conservative treatment.

    abstract:BACKGROUND:The aim of this paper was to report two cases of extrauterine disease in patients with early stage endometrial cancer (EC) who desired fertility-sparing management. CASES:Two patients presenting an apparent early stage EC and desiring conservative management. The two patients, aged 35 and 36 years old, had ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1016/j.ygyno.2004.09.034

    authors: Morice P,Fourchotte V,Sideris L,Gariel C,Duvillard P,Castaigne D

    更新日期:2005-01-01 00:00:00

  • Molecular subtypes of clear cell carcinoma of the endometrium: Opportunities for prognostic and predictive stratification.

    abstract:OBJECTIVE:Our aim was to characterize the pathological, molecular and clinical outcomes of clear cell carcinoma of the endometrium (CCC). METHODS:CCC underwent ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer) classification identifying four molecular subtypes: i) 'POLEmut' for ECs with pathogenic P...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2020.04.043

    authors: Kim SR,Cloutier BT,Leung S,Cochrane D,Britton H,Pina A,Storness-Bliss C,Farnell D,Huang L,Shum K,Lum A,Senz J,Lee CH,Gilks CB,Hoang L,McAlpine JN

    更新日期:2020-07-01 00:00:00

  • Comparison of neutropenia in a randomized, crossover trial of 3-, 6-, and 24-h infusions of paclitaxel.

    abstract:OBJECTIVE:Paclitaxel is most commonly infused over 3 hs rather than the original schedule of 24 h as the briefer infusion duration results in greater convenience, similar efficacy, significantly less myelosuppression, and less cost. While differences in toxicity between 3- and 24-h infusions are well described, there i...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0090-8258(03)00459-1

    authors: Jennens R,Rischin D,Yuen K,Toner G,Millward M

    更新日期:2003-10-01 00:00:00

  • Absorbable synthetic mesh (910-polyglactin) intestinal sling to reduce radiation-induced small bowel injury in patients with pelvic malignancies.

    abstract::Absorbable synthetic mesh (910-polyglactin) was used to create an intestinal sling in six patients undergoing surgical staging of pelvic malignancies prior to radiation therapy. All patients had effective compartmentalization of small intestine out of the pelvis which persisted throughout the duration of radiation the...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/0090-8258(88)90227-2

    authors: Soper JT,Clarke-Pearson DL,Creasman WT

    更新日期:1988-03-01 00:00:00

  • Establishment and characterization of a cell line (CUMC-3) derived from a human squamous carcinoma of the uterine cervix.

    abstract::A new cell line, CUMC-3, has been derived from an invasive nonkeratinizing squamous cell carcinoma of the uterine cervix in a 32-year-old patient. It has been maintained in long-term culture for 59 months, and passaged over 310 times. Monolayer-cultured cells were polygonal in shape, showing a pavement-like arrangemen...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1006/gyno.1995.1098

    authors: Kim JW,Cho YH,Lyu MS,Lee CG,Jung JK,Kim SJ,Namkoong SE

    更新日期:1995-04-01 00:00:00

  • First-line treatment regimens and the role of consolidation therapy in advanced ovarian cancer.

    abstract::Current first-line management for advanced ovarian cancer consists of cytoreductive surgery followed by chemotherapy, usually with a platinum/taxane combination. Although this approach has been shown to achieve overall response rates of 70-80% in clinical trials, the majority of patients relapse. A number of different...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审

    doi:10.1016/s0090-8258(03)00472-4

    authors: Stuart GC

    更新日期:2003-09-01 00:00:00

  • The cost-effectiveness of selective lymphadenectomy based on a preoperative prediction model in patients with endometrial cancer: insights from the US and Korean healthcare systems.

    abstract:OBJECTIVE:The aim of this study was to determine the cost-effectiveness of selective lymphadenectomy using a preoperative prediction model compared to routine lymphadenectomy for patients undergoing surgery for endometrial cancer in the US and Korea. METHODS:We used a modified Markov model to estimate clinical and eco...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章

    doi:10.1016/j.ygyno.2014.09.020

    authors: Lee JY,Cohn DE,Kim Y,Lee TJ,Barnett JC,Kim JW,Jeon YW,Kim K,Park SM,Kang S

    更新日期:2014-12-01 00:00:00