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Patient compliance for postoperative radiotherapy and survival outcome of women with stage I endometrioid endometrial cancer
Author(s) -
Matsuo Koji,
Machida Hiroko,
Ragab Omar M.,
GarciaSayre Jocelyn,
Yessaian Annie A.,
Roman Lynda D.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24690
Subject(s) - medicine , hazard ratio , radiation therapy , endometrial cancer , stage (stratigraphy) , guideline , confidence interval , proportional hazards model , retrospective cohort study , oncology , cancer , gynecology , surgery , pathology , paleontology , biology
Background and Objectives To examine characteristics and survival outcome of women with endometrial cancer who declined postoperative radiotherapy. Methods A retrospective study was conducted to examine surgically‐treated grade 1‐2 stage IB and grade 3 stage IA‐IB endometrioid endometrial cancer in the Surveillance, Epidemiology, and End Results Program between 1983 and 2013 ( n = 10 613). Associations of patient declination for guideline‐based postoperative radiotherapy and clinico‐pathological demographics or survival outcome were examined on multivariable analysis. Results There were 323 (3.0%) women who declined adjuvant radiotherapy. Women who declined postoperative radiotherapy were more likely to be older, White, Western U.S. residents, and register in recent years (all, adjusted‐ P < 0.05). On multivariable analysis, patient declination for guideline‐based postoperative radiotherapy remained an independent prognostic factor for decreased endometrial cancer‐specific survival in unstaged grade 1‐2 stage IB or staged/unstated grade 3 stage IA‐IB diseases (adjusted‐hazard ratio 1.84, 95% confidence interval 1.34‐2.51, P = 0.001). Association of patient declination for guideline‐based postoperative radiotherapy and decreased overall survival remained independent in the entire cohort on multivariable analysis (adjuvant‐hazard ratio 1.71, 95% confidence interval 1.44‐2.02, P < 0.001). Conclusions Our study suggested that patient compliance to guideline‐based postoperative radiotherapy is a prognostic factor for women with stage I endometrioid endometrial cancer.