Impact of adjuvant therapy on oncologic outcomes in uterine-confined clear cell carcinoma of the endometrium Journal Article

   


Authors: Rios-Doria, E.; Nobre, S. P.; Sassine, D.; Glaser, G.; Eriksson, A. G.; Ataseven, B.; du Bois, A.; Makker, V.; Alektiar, K.; Leitao, M. M.; Abu-Rustum, N. R.; Mueller, J. J.
Article Title: Impact of adjuvant therapy on oncologic outcomes in uterine-confined clear cell carcinoma of the endometrium
Abstract: Objectives: To determine the impact of adjuvant therapy on oncologic outcomes in patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IA, IB, or II endometrial clear cell carcinoma (ECCC). Methods: We conducted a retrospective review at 4 international institutions. Patients with newly diagnosed clinical stage I or II disease of either clear cell or mixed histology with a clear cell component treated between 01/01/2000–12/31/2015 were included. Oncologic outcomes were assessed for patients based on adjuvant treatment received, including chemotherapy, radiation, or chemotherapy with radiation. Results: Of 125 patients identified and analyzed, 77 (61.6%) had clear cell histology and 118 (94.4%) had stage I disease. Median age at diagnosis was 65 years (range, 33–91). All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and lymph node assessment. Twenty-five patients (20.0%) underwent surgical management alone and 100 (80.0%) received adjuvant therapy: 20 (16.0%) received postoperative chemotherapy, 47 (37.6%) received postoperative radiation, and 33 (26.4%) received postoperative chemotherapy with radiation. Median follow-up was 88.4 months (range, <1–234). Progression-free survival (PFS) or overall survival (OS) did not significantly differ between surgery alone and type of adjuvant therapy (P = 0.18 and P = 0.56, respectively). Patients with mixed ECCC did not have a survival advantage over those with pure ECCC (5-year PFS rate, 85.0% vs 82.7%, P = 0.77; 5-year OS rate, 88.3% vs 91.2%, P = 0.94). Conclusions: Receipt of adjuvant therapy in surgically staged I/II ECCC did not appear to offer a survival advantage over observation alone. Adjuvant therapy in early-stage ECCC with consideration of molecular classification should be evaluated. © 2024 Elsevier Inc.
Keywords: adult; cancer chemotherapy; controlled study; aged; cancer surgery; major clinical study; overall survival; postoperative period; adjuvant therapy; cancer adjuvant therapy; cancer staging; follow up; endometrial cancer; antineoplastic agent; hysterectomy; progression free survival; cohort analysis; retrospective study; histology; lymph node; international federation of gynecology and obstetrics; early stage; very elderly; cell component; human; female; article; endometrial clear cell carcinoma; endometrial clear cell; bilateral salpingooophorectomy
Journal Title: Gynecologic Oncology
Volume: 190
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2024-01-01
Start Page: 236
End Page: 242
Language: English
DOI: 10.1016/j.ygyno.2024.08.019
PROVIDER: scopus
PUBMED: 39243699
PMCID: PMC11560716
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85203169926&doi=10.1016%2fj.ygyno.2024.08.019&partnerID=40&md5=9ad39032c2a3ba4703def08c3e3fb5be
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Jennifer Mueller -- Source: Scopus
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MSK Authors
  1. Vicky Makker
    265 Makker
  2. Kaled M Alektiar
    333 Alektiar
  3. Mario Leitao
    575 Leitao
  4. Nadeem Abu-Rustum
    888 Abu-Rustum
  5. Jennifer Jean Mueller
    186 Mueller
  6. Silvana Pedra Nobre
    24 Pedra Nobre
  7. Dib Sassine
    12 Sassine
  8. Eric Vincent Rios-Doria
    35 Rios-Doria
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