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Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic‐surgical approach
Author(s) -
Larson Dale M.,
Copeland Larry J.,
Gallager H. Stephen,
Kong Joseph P.,
Wharton J. Taylor,
Stringer C. Allen
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880415)61:8<1528::aid-cncr2820610808>3.0.co;2-9
Subject(s) - medicine , occult , stage (stratigraphy) , surgery , carcinoma , radiation therapy , lymph node , hysterectomy , pelvis , radiology , alternative medicine , pathology , biology , paleontology
Since one third of the patients with Stage II endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty‐three patients with Stage II 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.