Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic-surgical approach

✍ Scribed by Dale M. Larson; Larry J. Copeland; H. Stephen Gallager; Joseph P. Kong; J. Taylor Wharton; C. Allen Stringer

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 633 KB
• Volume: 61
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19880415)61:8<1528::aid-cncr2820610808>3.0.co;2-9

✦ Synopsis

Since one third of the patients with Stage I1 endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty-three patients with Stage I1 endometrial carcinoma were treated between January 1964 and December 1983. Sixty-nine patients (83%) received combined whole-pelvic irradiation and surgery, five (6%) had surgery alone and nine (11%) had radiotherapy alone. Five-year actuarial survival rates were 67%, 60%, and 38%, respectively. No pelvic recurrence occurred in the 69 patients who received the combined therapy, and there was no vaginal recurrence in the 80 patients treated with intracavity radium. There was a significantly lower incidence of pelvic lymph node metastases (P = 0.03) in patients treated with preoperative irradiation. The median time to recurrence was 17 months, with 67% of the recurrences diagnosed before 2 years, and 88% within 5 years. Ten patients (12%) incurred severe complications and three died as a result. Whole-pelvic irradiation, intracavity radium, and hysterectomy are effective treatment for occult pelvic and vaginal disease.