Impact of adjuvant external-beam radiation therapy in early-stage uterine papillary serous and clear cell carcinoma.

Abstract

PURPOSE:

Adjuvant radiation therapy (RT) in early-stage high- to intermediate-risk endometrioid adenocarcinoma is well established and has been shown to improve locoregional control. Its role in the management of early-stage clear cell carcinoma and uterine papillary serous carcinoma (UPSC) remains controversial.

METHODS AND MATERIALS:

Using the Surveillance Epidemiology and End Results database, we identified women with American Joint Committee on Cancer Stage Sixth Edition. Stage IA-IIB clear cell carcinoma or UPSC who underwent hysterectomy with or without adjuvant RT between 1988 and 2003. We used Kaplan-Meier and Cox regression analysis to compare overall survival (OS) for all patients.

RESULTS:

We identified 1,333 women of whom 451 had clear cell carcinoma and 882 had UPSC. Of those patients, 775 underwent surgery alone and 558 received adjuvant RT as well. For Stages I-IIB disease, the median OS with surgery alone was 106 months, vs. 151 months with adjuvant RT (p = 0.006). On subgroup analysis, we saw the benefit from adjuvant RT only in Stage IB-C patients. For Stage IB disease, patients undergoing surgery alone had a median OS of 117 months, vs. median survival not reached with the addition of RT (p = 0.006). For Stage IC disease, surgery alone had a median OS of 35 months vs. 120 months with RT (p = 0.001). Although the apparent benefit of RT diminished when measured via multivariate analysis, the impact of RT on survival did show a trend toward significance (hazard ration 0.808, confidence interval 95% 0.651-1.002, p = 0.052)

CONCLUSION:

In FIGO Stage IB-C papillary serous and clear cell uterine carcinoma, adjuvant RT seems to play an important role in improving survival.

• Authors: Anne Kim, David Schreiber, Justin Rineer, Kwang Choi, Marvin Rotman
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 81 Issue 4 Pg. e639-44 (Nov 15 2011) ISSN: 1879-355X [Electronic] United States
• PMID: 21507584 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Adenocarcinoma, Clear Cell (mortality, pathology, radiotherapy, surgery)
• Aged
• Cystadenocarcinoma, Papillary (mortality, pathology, radiotherapy, surgery)
• Cystadenocarcinoma, Serous (mortality, pathology, radiotherapy, surgery)
• Female
• Humans
• Hysterectomy (methods, mortality)
• Neoplasm Staging
• Radiotherapy, Adjuvant (mortality)
• Regression Analysis
• SEER Program