Surgical cytoreduction in stage IV endometrioid endometrial carcinoma Journal Article


Authors: Shih, K. K.; Yun, E.; Gardner, G. J.; Barakat, R. R.; Chi, D. S.; Leitao, M. M. Jr
Article Title: Surgical cytoreduction in stage IV endometrioid endometrial carcinoma
Abstract: Objective: To evaluate the role of surgical cytoreduction and the amount of residual disease in patients with newly diagnosed stage IV endometrioid endometrial carcinoma (EC). Methods: Patients with stage IV EC of endometrioid histology who underwent surgery at our institution from 1977 to 2003 were identified. Patients with microscopic stage IV disease were excluded. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan Meier method and compared with log-rank test. Results: A total of 58 patients were identified, of which 9 (15.5%) had no gross residual (NGR) after surgery, 11 (19.0%) had residual disease ≤ 1 cm, 32 (55.1%) had residual disease > 1 cm, and 6 (10.3%) had no cytoreduction attempted. The median PFS was 11.1 months (95% CI, 9.8-12.3) and the median OS was 19.2 months (95% CI, 8.5-29.9) for the cohort. The median PFS was 40.3 months (95% CI, 0-93.9) for patients with NGR disease, 11 months (95% CI, 9.9-12.1) for patients with any residual disease, and 2.2 months (95% CI, 0.1-4.2) for patients who did not have attempted cytoreduction (P < 0.001). The median OS was 42.2 months (95% CI, not estimable) for patients with NGR disease, 19 months (95% CI, 13.9-24.1) for patients with any residual disease, and 2.2 months (95% CI, 0.1-4.2) for patients that did not have attempted cytoreduction (P < 0.001). Conclusion: Though stage IV endometrioid EC has a poor prognosis, surgical cytoreduction to no gross residual disease in a highly select group of patients is associated with improved survival. © 2011 Elsevier Inc.
Keywords: adult; controlled study; aged; major clinical study; overall survival; doxorubicin; fluorouracil; paclitaxel; adjuvant therapy; cancer adjuvant therapy; cancer radiotherapy; cancer staging; endometrioid carcinoma; endometrium carcinoma; surgical cytoreduction; cytoreductive surgery; carboplatin; progression free survival; cyclophosphamide; cancer hormone therapy; minimal residual disease; tamoxifen; kaplan meier method; navelbine; endometrium; log rank test; megestrol; medroxyprogesterone; endometrioid endometrial carcinoma; stage iv endometrial cancer
Journal Title: Gynecologic Oncology
Volume: 122
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2011-09-01
Start Page: 608
End Page: 611
Language: English
DOI: 10.1016/j.ygyno.2011.05.020
PROVIDER: scopus
PUBMED: 21664663
DOI/URL:
Notes: --- - "Export Date: 3 October 2011" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Ginger J Gardner
    273 Gardner
  2. Eric Young Yun
    1 Yun
  3. Richard R Barakat
    629 Barakat
  4. Dennis S Chi
    712 Chi
  5. Mario Leitao
    579 Leitao
  6. Esther Mannyoung Yun
    2 Yun
  7. Karin Kuan-Hui Shih
    41 Shih