(P020) Adjuvant Chemoradiation Is Associated With Improved Overall Survival in Patients With Stage III Endometrial Cancer: An Analysis of the National Cancer Data Base

Publication
Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

In this large population-based cohort, adjuvant chemoradiotherapy is associated with improved OS in patients with stage III endometrial cancer.

Charles C. Vu, MD, Karna Sura, MD, Maha S. Jawad, MD, Sirisha R. Nandalur, MD; Beaumont Health System

OBJECTIVE: To compare various adjuvant treatment strategies in patients with stage III endometrial cancer.

METHODS: The National Cancer Data Base (NCDB) is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The NCDB was used to analyze a cohort of women with pathologic stage III endometrial cancer. All patients were staged with hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. All patients who were treated with chemotherapy received multiagent chemotherapy. Statistical analysis was performed using Kaplan-Meier curves, log-rank tests, and multivariate Cox proportional hazards regression. Demographic, tumor, treatment, and comorbidity covariates were included in the multivariate model.

RESULTS: A total of 12,501 patients with stage III endometrial cancer were included in this analysis; 2,439 (20%) patients received adjuvant chemoradiation, 1,280 (11%) received adjuvant radiotherapy (RT) alone, 5,132 (41%) received adjuvant chemotherapy alone, and 3,650 (29%) received no adjuvant therapy. The median follow-up time was 36 months (interquartile range: 19–62 mo). Estimated unadjusted 5-year overall survival (OS) was 70.9% for chemoradiation, 60.9% for radiotherapy alone, 56.5% for chemotherapy alone, and 50.8% for no adjuvant treatment (P < .001 using log-rank test). After accounting for demographic, tumor, and comorbidity covariates, treatment with chemoradiation remained predictive of improved OS in the final multivariate model. Tumor characteristics that were predictive of poorer survival on multivariate analysis included larger tumor size, higher grade, increased number of positive lymph nodes, and presence of lymphovascular space invasion.

CONCLUSION: In this large population-based cohort, adjuvant chemoradiotherapy is associated with improved OS in patients with stage III endometrial cancer. Strong consideration of adjuvant combined-modality therapy should be given for patients with stage III endometrial cancer, pending publication of data from randomized trials (eg, the Gynecologic Oncology Group trial GOG 258, and PORTEC-3).

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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