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Titolo:
Significant pelvic recurrence in high-risk pathologic stage I-IV endometrial carcinoma patients after adjuvant chemotherapy alone: Implications for adjuvant radiation therapy
Autore:
Mundt, AJ; McBride, R; Rotmensch, J; Waggoner, SE; Yamada, SD; Connell, PP;
Indirizzi:
Univ Chicago Hosp, Dept Radiat & Cellular Oncol, Gynecol Oncol Sect, Chicago, IL 60637 USA Univ Chicago Hosp Chicago IL USA 60637 Oncol Sect, Chicago, IL 60637 USA Univ Chicago Hosp, Dept Obstet & Gynecol, Gynecol Oncol Sect, Chicago, IL 60637 USA Univ Chicago Hosp Chicago IL USA 60637 Oncol Sect, Chicago, IL 60637 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 5, volume: 50, anno: 2001,
pagine: 1145 - 1153
SICI:
0360-3016(20010801)50:5<1145:SPRIHP>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
GYNECOLOGIC-ONCOLOGY-GROUP; PAPILLARY SEROUS CARCINOMA; BREAST-CANCER PATIENTS; CYCLOPHOSPHAMIDE PAC; RANDOMIZED TRIAL; POSTOPERATIVE RADIOTHERAPY; PROGNOSTIC FACTORS; FAILURE PATTERNS; SURGICAL STAGE; LYMPH-NODES;
Keywords:
endometrial cancer; adjuvant chemotherapy; pattern of failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Mundt, AJ Univ Chicago Hosp, Dept Radiat & Cellular Oncol, Gynecol Oncol Sect, MC 9006,5758 S Maryland Ave, Chicago, IL 60637 USA Univ Chicago Hosp MC 9006,5758 S Maryland Ave Chicago IL USA 60637
Citazione:
A.J. Mundt et al., "Significant pelvic recurrence in high-risk pathologic stage I-IV endometrial carcinoma patients after adjuvant chemotherapy alone: Implications for adjuvant radiation therapy", INT J RAD O, 50(5), 2001, pp. 1145-1153

Abstract

Objective: To evaluate the risk of pelvic recurrence (PVR) in high-risk pathologic Stage I-IV endometrial carcinoma patients after adjuvant chemotherapy alone. Methods: Between 1992 and 1998, 43 high-risk endometrial cancer patients received adjuvant chemotherapy. All patients underwent primary surgery consisting of total abdominal hysterectomy and bilateral salpingo-oophorectomy. No patients received preoperative radiation therapy (AT). Regional lymph nodes and peritoneal cytology were sampled in 62.8% and 83.7% of cases, respectively. Most patients had Stage III-IV disease (83.7%) or unfavorable histology tumors (74.4%). None had evidence of extra-abdominal disease. All patients received 4-6 cycles of chemotherapy as the sole adjuvant therapy, consisting primarily of cisplatin and doxorubicin. Recurrent disease sites were divided into pelvic (vaginal, nonvaginal) and extrapelvic (para-aortic, upper abdomen, liver, and extra-abdominal). Median follow-up was 27 months (range, 2-96 months). Results: Twenty-nine women (67.4%) relapsed. Seventeen (39.5%) recurred inthe pelvis and 23 (55.5%) in extrapelvic sites. The 3-year actuarial PVR rate was 46.5%. The most significant factors correlated with PVR were cervical involvement (CI) (p = 0.01) and adnexal (p = 0.05) involvement. Of the 17 women who developed a PVR, 8 relapsed in the vagina, 3 in the nonvaginal pelvis, and 6 in both. The 3-year vaginal and nonvaginal PVR rates were 37.8% and 26%, respectively. The most significant factor correlated with vaginal PVR was CI (p = 0.0007). Deep myometrial invasion (p = 0.02) and lymph nodal involvement (p = 0.03) were both correlated with nonvaginal PVR. Nine of the 29 relapsed patients (31%) developed PVR as their only (6) ar first site (3) of recurrence. Factors associated with a higher rate of PVR (as the first or only site) were CI and Stage I-II disease. Conclusions: PVR is common in high-risk pathologic Stage I-IV endometrial cancer patients after adjuvant chemotherapy alone. These results support the continued use of locoregional RT in patients undergoing adjuvant chemotherapy. Further studies are needed to test the addition of chemotherapy to locoregional RT. (C) 2001 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 08:32:45