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Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer.

Publication ,  Journal Article
Havrilesky, LJ; Secord, AA; O'Malley, DM; Broadwater, G; Bae-Jump, V; Cohn, DE; Gehrig, PA
Published in: Gynecol Oncol
August 2009

OBJECTIVE: To determine factors related to recurrence and survival in women with stage IIIA endometrial cancer; to examine outcomes of women with IIIA1 disease. METHODS: Multi-institutional analysis of women with stage IIIA endometrial carcinoma undergoing hysterectomy, bilateral salpingo-oophorectomy, lymphadenectomy, and pelvic cytology between 1980 and 2008. Overall survival (OS) and recurrence-free disease specific survival (RFDSS) were compared using Kaplan-Meier method, univariate and multivariate analyses. RESULTS: 98 women underwent surgical staging for stage IIIA endometrial carcinoma. Pelvic washings were positive in 53%, serosa in 18%, and adnexae in 45%. Forty were IIIA1; 58 were IIIA2 (adnexal/serosal involvement). Median number of lymph nodes was 19 (range 1-73). Adjuvant treatment was given to 88%: radiotherapy--21%, chemotherapy - 19%, chemotherapy and radiotherapy--19%, hormonal therapy--16%, and intraperitoneal P-32 - 11%. Five-year OS and RFDSS for IIIA1 were 77% and 76%, respectively; and for IIIA2 were 75% and 73%, respectively (p=NS for both). Patients with IIIA1 disease were less likely to receive chemotherapy or radiotherapy than those with IIIA2 disease (p=0.0035). Older age (Hazard ratio 1.24; 95% CI 1.00-1.54), non-Caucasian race (HR 5.35; 95% CI 1.96-14.5), and cervical metastases (HR 3.3; 95% CI 1.3-8.7) predicted lower RFDSS in multivariate analysis. Among 24 patients meeting NCCN's observation criteria (IIIA1, non-serous, and FIGO grade 1-2), 0/12 receiving adjuvant treatment recurred, while 1/12 not receiving adjuvant treatment recurred. CONCLUSIONS: Surgically assessed stage IIIA endometrial adenocarcinoma recurs in approximately 20-25% of cases. A subset of stage IIIA1 with very low risk factors may be appropriate candidates for observation.

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

August 2009

Volume

114

Issue

2

Start / End Page

279 / 283

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Ovariectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphatic Metastasis
  • Hysterectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Havrilesky, L. J., Secord, A. A., O’Malley, D. M., Broadwater, G., Bae-Jump, V., Cohn, D. E., & Gehrig, P. A. (2009). Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer. Gynecol Oncol, 114(2), 279–283. https://doi.org/10.1016/j.ygyno.2009.04.030
Havrilesky, Laura J., Angeles Alvarez Secord, David M. O’Malley, Gloria Broadwater, Victoria Bae-Jump, David E. Cohn, and Paola A. Gehrig. “Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer.Gynecol Oncol 114, no. 2 (August 2009): 279–83. https://doi.org/10.1016/j.ygyno.2009.04.030.
Havrilesky LJ, Secord AA, O’Malley DM, Broadwater G, Bae-Jump V, Cohn DE, et al. Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer. Gynecol Oncol. 2009 Aug;114(2):279–83.
Havrilesky, Laura J., et al. “Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer.Gynecol Oncol, vol. 114, no. 2, Aug. 2009, pp. 279–83. Pubmed, doi:10.1016/j.ygyno.2009.04.030.
Havrilesky LJ, Secord AA, O’Malley DM, Broadwater G, Bae-Jump V, Cohn DE, Gehrig PA. Multicenter analysis of recurrence and survival in stage IIIA endometrial cancer. Gynecol Oncol. 2009 Aug;114(2):279–283.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

August 2009

Volume

114

Issue

2

Start / End Page

279 / 283

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Ovariectomy
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphatic Metastasis
  • Hysterectomy