INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER stage I uterine ...

[Pages:19]Int J Gynecol Cancer: first published as 10.1136/ijgc-2020-001379 on 15 July 2020. Downloaded from on December 31, 2023 by guest. Protected by copyright.

INTERNATIONAL JOURNAL OF

GYNECOLOGICAL CANCER

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Original research

Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

Dimitrios Nasioudis , Allison Grace Roy, Emily M Ko, Lori Cory, Robert L Giuntoli II, Ashley F Haggerty, Sarah H Kim, Mark A Morgan, Nawar A Latif

Additional material is published online only. To view please visit the journal online ( 2020-001379). Division of Gynecologic Oncology, Penn Medicine, Philadelphia, Pennsylvania, USA

Correspondence to Dr Dimitrios Nasioudis, Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; dimitrios. nasioudis@uphs.upenn.e du

Received 10 March 2020 Revised 5 June 2020 Accepted 9 June 2020 Published Online First 15 July 2020

? IGCS and ESGO 2020. No commercial re-use. See rights and permissions. Published by BMJ. To cite: Nasioudis D, Roy AG, Ko EM, et al. Int J Gynecol Cancer 2020;30:1089?1094.

HIGHLIGHTS ? Among 1709 patients with uterine serous carcinoma confined to the endometrium, 48.7% did not receive adjuvant

treatment. ? Adjuvant chemotherapy and chemoradiation were associated with better survival compared with observation. ? There was no difference in survival between observation and radiation only.

Abstract

Objectives The role of adjuvant treatment for early- stage uterine serous carcinoma is not defined. The goal of this study was to investigate the impact of adjuvant treatment on survival of patients with tumors confined to the endometrium. Methods Patients diagnosed with stage I uterine serous carcinoma with no myometrial invasion between January 2004 and December 2015 who underwent hysterectomy with at least 10 lymph nodes removed were identified from the National Cancer Database. Adjuvant treatment patterns defined as receipt of chemotherapy and/or radiotherapy within 6 months from surgery were investigated and overall survival was evaluated using Kaplan?Meier curves, and compared with the log-rank test for patients with at least one month of follow-up. A Cox analysis was performed to control for confounders. Results A total of 1709 patients were identified; 833 (48.7%) did not receive adjuvant treatment, 348 (20.4%) received both chemotherapy and radiotherapy, 353 (20.7%) received chemotherapy only, and 175 (10.2%) received radiotherapy only. Five-year overall survival rates for patients who did not receive adjuvant treatment (n=736) was 81.9%, compared with 91.3% for those who had chemoradiation (n=293), 85.1% for those who received radiotherapy only (n=143), and 91.0% for those who received chemotherapy only (n=298) (p ................
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