Patterns of relapse in stage I-II uterine papillary serous carcinoma treated with adjuvant intravaginal radiation (IVRT) with or without chemotherapy Journal Article
| Authors: | Desai, N. B.; Kiess, A. P.; Kollmeier, M. A.; Abu-Rustum, N. R.; Makker, V.; Barakat, R. R.; Alektiar, K. M. |
| Article Title: | Patterns of relapse in stage I-II uterine papillary serous carcinoma treated with adjuvant intravaginal radiation (IVRT) with or without chemotherapy |
| Abstract: | Objective To evaluate patterns of relapse in early stage uterine papillary carcinoma (UPSC) patients receiving adjuvant intravaginal radiotherapy (IVRT) with or without chemotherapy. Methods From 1/1996 to 12/2010, 77 women with stage I-II UPSC underwent surgery followed by IVRT (median 21 Gy). Stage IA patients without residual disease at surgery were excluded. IVRT and chemotherapy (carboplatin/taxane) was given to 61 (79%) patients and IVRT alone to 16 (21%). The median follow-up was 62 months for surviving patients. Results Of the 77 patients, 11 (14%) relapsed as follows: vaginal 2 (3%), pelvic 5 (6%), para-aortic 5 (6%), peritoneal 6 (8%), and other distant sites 8 (10%). Of the 5 pelvic relapses, 2 were isolated and were salvaged. In those treated without chemotherapy, only 1/16 developed recurrence (mediastinal). The 5-year vaginal, pelvic, para-aortic, peritoneal, and distant recurrence rates were 2.7% (C.I. 0-6.2%), 5.8% (C.I. 0.6-11.0%), 5.4% (C.I. 0.6-10.1%), 5.3% (C.I. 0.5-10.1%) and 6.6% (C.I. 1.4-11.8%), respectively. The 5-year disease-free survival (DFS), and overall survival (OS) were 88% (C.I. 81-95%), and 91% (C.I. 84-97%), respectively. The only predictor of worse 5-year pelvic control was stage (96.2% stage IA vs 87.7% for stage IB-II, p = 0.043). Conclusions In stage I-II UPSC patients who predominantly receive adjuvant chemotherapy, IVRT as the sole form of adjuvant RT provides excellent locoregional control. The risk of isolated pelvic recurrence is too low to warrant routine use of external pelvic RT. © 2013 Elsevier Inc. |
| Keywords: | adult; cancer chemotherapy; cancer survival; aged; major clinical study; overall survival; cancer recurrence; salvage therapy; multimodality cancer therapy; paclitaxel; cancer radiotherapy; disease free survival; cancer staging; recurrence risk; follow up; endometrium carcinoma; hysterectomy; paraaortic lymph node; carboplatin; progression free survival; computer assisted tomography; multiple cycle treatment; retrospective study; cancer survivor; docetaxel; body mass; minimal residual disease; adjuvant chemotherapy; brachytherapy; cancer control; peritoneum metastasis; oral contraceptive agent; uterine cancer; endometrium biopsy; ascites fluid cytology; vagina carcinoma; patient preference; papanicolaou test; ivrt; lymph vessel metastasis; papillary serous; human; female; priority journal; article; patterns of relapse; intravaginal radiotherapy |
| Journal Title: | Gynecologic Oncology |
| Volume: | 131 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-12-01 |
| Start Page: | 604 |
| End Page: | 608 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2013.09.019 |
| PROVIDER: | scopus |
| PUBMED: | 24055615 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2014 -- CODEN: GYNOA -- Source: Scopus |
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