Document Detail

Adjuvant radiation for early stage endometrial cancer with lymphovascular invasion.
MedLine Citation:
PMID:  18639922     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the impact of the decrease in use of postoperative pelvic external beam radiation (EBRT) in favor of intravaginal RT (IVRT) alone in patients with early stage endometrial cancer who had lymphovascular invasion (LVI). METHODS: Between 11/1988 and 5/2005, 126 patients treated with simple hysterectomy and postoperative RT had a final pathologic diagnosis of stage IB-IIB adenocarcinoma of endometrioid histology with documented LVI. The patients were divided into two groups based on the era of treatment, (early era: 1988-1996, vs. late era: 1997-2005), in order to best capture the shift away from the routine use of EBRT in favor of surgical staging and IVRT. RESULTS: Of the 126 patients, 35% (n=44) were treated in the early era and 65% (n=82) in the late era. The two groups were balanced in regards to age, race, depth of myometrial invasion, histologic grade, and cervical involvement. Significantly more patients had surgical staging and received IVRT alone in the late than early era (p=0.0001, 0.004, respectively). The rate of pelvic control was 93% for the early era compared to 97% for latter era (p=0.3). There was no significant impact of the treatment era on vaginal control, disease-free survival, or overall survival. CONCLUSIONS: These data suggest that the mere presence of LVI need not trigger the use of pelvic EBRT. Instead, the decision on whether to omit EBRT in patients with LVI should be made in the context of a patient's competing risk factors and comorbid conditions.
Victoria J Croog; Nadeem R Abu-Rustum; Richard R Barakat; Kaled M Alektiar
Publication Detail:
Type:  Journal Article     Date:  2008-07-18
Journal Detail:
Title:  Gynecologic oncology     Volume:  111     ISSN:  1095-6859     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-16     Completed Date:  2008-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-54     Citation Subset:  IM    
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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MeSH Terms
Aged, 80 and over
Carcinoma, Endometrioid / blood supply,  pathology,  radiotherapy*,  surgery
Disease-Free Survival
Endometrial Neoplasms / blood supply,  pathology,  radiotherapy*,  surgery
Lymphatic Vessels / pathology
Middle Aged
Neoplasm Recurrence, Local / pathology
Neoplasm Staging
Neovascularization, Pathologic / pathology
Radiotherapy, Adjuvant
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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