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Analysis of risk factors for recurrence and effective adjuvant therapy in patients with endometrial cancer
Author(s) -
Goto Tomoko,
Takano Masayoshi,
Kita Tsunekazu,
Kikuchi Yoshihiro
Publication year - 2002
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1046/j.1341-8076.2002.00023.x
Subject(s) - medicine , endometrial cancer , stage (stratigraphy) , adjuvant therapy , adjuvant , risk factor , radiation therapy , chemotherapy , multivariate analysis , surgery , oncology , cancer , paleontology , biology
Objective: The aim of this study was to explore risk factors for recurrence and effective adjuvant therapy in endometrial cancer. Methods: Between 1985 and 1999, 170 patients with uterine endometrial cancer received initial therapy at the National Defense Medical College Hospital. We retrospectively analyzed risk factors including; histopathological features, operative procedures, adjuvant therapies and surgical staging. Results: Although the prognosis in stage I and II patients was fairly good, recurrences were observed in patients with stage Ib or worse. Vagina walls were the frequent site of recurrence. About a half of relapses which occurred within seven months after surgery were observed during adjuvant chemotherapy. Multivariate analysis revealed that myometrial invasion ( P = 0.0231) was the only risk factor for recurrence. Although the prognosis in stage III and IV patients was generally poor, serosal invasion in stage III disease seemed to be an im‐portant risk factor. With regard to adjuvant therapy in stage I–III patients who could receive optimal cytoreductive surgery; the risk of recurrence was significantly ( P = 0.0127) lower in patients receiving radiation therapy than in those receiving chemotherapy including platinum agents. Conclusion: The data suggested that in stage I–III patients with optimal cytoreductive surgery, myometrial invasion is an independent risk factor for recurrence and radiation therapy is more effective than chemotherapy as adjuvant therapy.