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02-01-2015 | Uterine cancer | Book chapter | Article

30. Treatment of Endometrial Cancer

Author: Patricia J. Eifel, MD

Publisher: Springer London

Abstract

Although most patients with endometrial cancer are cured with hysterectomy alone, a subset of patients with relatively high-risk disease may benefit from effective adjuvant treatments. Investigators are still attempting to define the indications for and risks and benefits of additional interventions, including lymphadenectomy, adjuvant radiation therapy, and adjuvant chemotherapy. In this chapter, the insights from and limitations of available trials will be summarized.
Literature
1.
Hendrickson M, et al. Uterine papillary serous carcinoma: a highly malignant form of endometrial adenocarcinoma. Am J Surg Pathol. 1982;6(2):93–108.CrossRefPubMed
2.
Kilgore LC, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol Oncol. 1995;56(1):29–33.CrossRefPubMed
3.
Kitchener H, et al. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373(9658):125–36.CrossRefPubMed
4.
Benedetti Panici P, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008;100(23):1707–16.CrossRefPubMed
5.
Corn BW, et al. Impact of improved irradiation technique, age and lymph node sampling on the severe complication rate of surgically staged endometrial cancer patients: a multivariate analysis. J Clin Oncol. 1994;12:510–5.PubMed
6.
Mariani A, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol. 2008;109(1):11–8.CrossRefPubMedCentralPubMed
7.
How J, et al. Accuracy of sentinel lymph node detection following intra-operative cervical injection for endometrial cancer: a prospective study. Gynecol Oncol. 2012;127(2):332–7.CrossRefPubMed
8.
Aalders J, et al. Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients. Obstet Gynecol. 1980;56(4):419–27.PubMed
9.
Blake P, et al. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis. Lancet. 2009;373(9658):137–46.CrossRefPubMed
10.
Creutzberg CL, et al. Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: the postoperative radiation therapy in endometrial carcinoma trial. J Clin Oncol. 2004;22(7):1234–41.CrossRefPubMed
11.
Keys HM, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group Study. Gynecol Oncol. 2004;92(3):744–51.CrossRefPubMed
12.
Nout RA et al. Vaginal brachytherapy versus external beam pelvic radiotherapy for high-intermediate risk endometrial cancer: results of the randomized PORTEC-2 trial. Proceedings of the 44th Annual Meeting of the American Society of Clinical Oncology, 2008: p. 181.
13.
Sorbe B, et al. External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium-risk endometrial carcinoma—a prospective randomized study. Int J Radiat Oncol Biol Phys. 2012;82(3):1249–55.CrossRefPubMed
14.
Scholten AN, et al. Postoperative radiotherapy for stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review. Int J Radiat Oncol Biol Phys. 2005;63(3):834–8.CrossRefPubMed
15.
Jhingran A, Burke TW, Eifel PJ. Definitive radiotherapy for patients with isolated vaginal recurrence of endometrial carcinoma after hysterectomy. Int J Radiat Oncol Biol Phys. 2003;56(5):1366–72.CrossRefPubMed
16.
Randall ME, et al. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006;24(1):36–44.CrossRefPubMed
17.
Maggi R, et al. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial. Br J Cancer. 2006;95(3):266–71.CrossRefPubMedCentralPubMed
18.
Susumu N, et al. Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group Study. Gynecol Oncol. 2008;108(1):226–33.CrossRefPubMed
19.
Kuoppala T, et al. Surgically staged high-risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs. sequential chemo-radiotherapy. Gynecol Oncol. 2008;110(2):190–5.CrossRefPubMed
20.
Hogberg T, et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer—results from two randomised studies. Eur J Cancer. 2010;46(13):2422–31.CrossRefPubMedCentralPubMed
21.
Klopp AH, et al. Node-positive adenocarcinoma of the endometrium: outcome and patterns of recurrence with and without external beam irradiation. Gynecol Oncol. 2009;115(1):6–11.CrossRefPubMed
22.
Secord AA, et al. A multicenter evaluation of sequential multimodality therapy and clinical outcome for the treatment of advanced endometrial cancer. Gynecol Oncol. 2009;114(3):442–7.CrossRefPubMed
23.
Secord AA, et al. A multicenter evaluation of adjuvant therapy in women with optimally resected stage IIIC endometrial cancer. Gynecol Oncol. 2013;128(1):65–70.CrossRefPubMed
24.
Greven K, et al. Final analysis of RTOG 9708: adjuvant postoperative irradiation combined with cisplatin/paclitaxel chemotherapy following surgery for patients with high-risk endometrial cancer. Gynecol Oncol. 2006;103(1):155–9.CrossRefPubMed
25.
Jhingran A, et al. A prospective phase II study of chemoradiation followed by adjuvant chemotherapy for FIGO stage I-IIIA (1988) uterine papillary serous carcinoma of the endometrium. Gynecol Oncol. 2013;129(2):304–9.CrossRefPubMed