title: Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic-surgical approach.
abstract: Since one third of the patients with Stage II endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty-three patients with Stage II endometrial carcinoma were treated between January 1964 and December 1983. Sixty-nine patients (83%) received combined whole-pelvic irradiation and surgery, five (6%) had surgery alone and nine (11%) had radiotherapy alone. Five-year actuarial survival rates were 67%, 60%, and 38%, respectively. No pelvic recurrence occurred in the 69 patients who received the combined therapy, and there was no vaginal recurrence in the 80 patients treated with intracavity radium. There was a significantly lower incidence of pelvic lymph node metastases (P = 0.03) in patients treated with preoperative irradiation. The median time to recurrence was 17 months, with 67% of the recurrences diagnosed before 2 years, and 88% within 5 years. Ten patients (12%) incurred severe complications and three died as a result. Whole-pelvic irradiation, intracavity radium, and hysterectomy are effective treatment for occult pelvic and vaginal disease.
authors.affiliation: Department of Gynecology, University of Texas M. D. Anderson Hospital and Tumor Institute at Houston.
authors.forename: D M
authors.initials: DM
authors.lastname: Larson
authors.forename: L J
authors.initials: LJ
authors.lastname: Copeland
authors.forename: H S
authors.initials: HS
authors.lastname: Gallager
authors.forename: J P
authors.initials: JP
authors.lastname: Kong
authors.forename: J T
authors.initials: JT
authors.lastname: Wharton
authors.forename: C A
authors.initials: CA
authors.lastname: Stringer
mesh_terms: D001918:Brachytherapy; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011867:Radioisotope Teletherapy; D014594:Uterine Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*