The selection of patients with axillary lymph node-negative breast cancer who should receive adjuvant therapy today is confused by an expanding arsenal of putative prognostic factors. The size of the primary tumor remains the dominant factor in sorting among this group of patients, with general agre
Analysis of risk factors for recurrence and effective adjuvant therapy in patients with endometrial cancer
β Scribed by Tomoko Goto; Masayoshi Takano; Tsunekazu Kita; Yoshihiro Kikuchi
- Publisher
- John Wiley and Sons
- Year
- 2002
- Tongue
- English
- Weight
- 41 KB
- Volume
- 28
- Category
- Article
- ISSN
- 1341-8076
No coin nor oath required. For personal study only.
β¦ Synopsis
Objective: The aim of this study was to explore risk factors for recurrence and effective adjuvant therapy in endometrial cancer.
Methods: Between 1985 and 1999, 170 patients with uterine endometrial cancer received initial therapy at the National Defense Medical College Hospital. We retrospectively analyzed risk factors including; histopathological features, operative procedures, adjuvant therapies and surgical staging.
Results: Although the prognosis in stage I and II patients was fairly good, recurrences were observed in patients with stage Ib or worse. Vagina walls were the frequent site of recurrence. About a half of relapses which occurred within seven months after surgery were observed during adjuvant chemotherapy. Multivariate analysis revealed that myometrial invasion (P = 0.0231) was the only risk factor for recurrence. Although the prognosis in stage III and IV patients was generally poor, serosal invasion in stage III disease seemed to be an imβportant risk factor. With regard to adjuvant therapy in stage IβIII patients who could receive optimal cytoreductive surgery; the risk of recurrence was significantly (P = 0.0127) lower in patients receiving radiation therapy than in those receiving chemotherapy including platinum agents.
Conclusion: The data suggested that in stage IβIII patients with optimal cytoreductive surgery, myometrial invasion is an independent risk factor for recurrence and radiation therapy is more effective than chemotherapy as adjuvant therapy.
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## Abstract ## BACKGROUND Current adjuvant hormone therapy in postmenopausal women with breast cancer is debatable between upfront aromatase inhibitors (AIs) and sequential treatment with tamoxifen. A major concern is the higher rate of early recurrences observed with sequential treatment. The aut