title: Postoperative radiotherapy for Stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review.
abstract: OBJECTIVE
  In 2000, the results of the multicenter Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial were published. This trial included 714 Stage I endometrial carcinoma patients randomly assigned to postoperative pelvic radiotherapy (RT) or no further treatment, excluding those with Stage IC, Grade 3, or Stage IB, Grade 1 lesions. Radiotherapy significantly decreased the risk of locoregional recurrence (4% vs. 14%), without affecting overall survival. In this report the long-term outcome and results with central pathology review are presented.
  
  
  METHODS
  The slides of 569 patients (80%) could be obtained for pathology review. Median follow-up for patients alive was 97 months. Analysis was done according to the intention-to-treat principle. The primary study endpoints were locoregional recurrence and death.
  
  
  RESULTS
  Ten-year locoregional relapse rates were 5% (RT) and 14% (controls; p < 0.0001), and 10-year overall survival was 66% and 73%, respectively (p = 0.09). Endometrial cancer related death rates were 11% (RT) and 9% (controls; p = 0.47). Pathology review showed a substantial shift from Grade 2 to Grade 1, but no significant difference for Grade 3. When cases diagnosed at review as Grade 1 with superficial myometrial invasion were excluded from the analysis, the results remained essentially the same, with 10-year locoregional recurrence rates of 5% (RT) and 17% (controls; p < 0.0001).
  
  
  CONCLUSIONS
  In view of the significant locoregional control benefit, radiotherapy remains indicated in Stage I endometrial carcinoma patients with high-risk features for locoregional relapse.
authors.affiliation: Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Astrid N
authors.initials: AN
authors.lastname: Scholten
authors.forename: Wim L J
authors.initials: WL
authors.lastname: van Putten
authors.forename: Henk
authors.initials: H
authors.lastname: Beerman
authors.forename: Vincent T H B M
authors.initials: VT
authors.lastname: Smit
authors.forename: Peter C M
authors.initials: PC
authors.lastname: Koper
authors.forename: Marnix L M
authors.initials: ML
authors.lastname: Lybeert
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Jobsen
authors.forename: Carla C
authors.initials: CC
authors.lastname: Wárlám-Rodenhuis
authors.forename: Karin A J
authors.initials: KA
authors.lastname: De Winter
authors.forename: Ludy C H W
authors.initials: LC
authors.lastname: Lutgens
authors.forename: Mat
authors.initials: M
authors.lastname: van Lent
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
mesh_terms: D000704:Analysis of Variance; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016019:Survival Analysis