Adjuvant radiation therapy in stage III node-positive uterine cancer.
OBJECTIVE
To determine the association of adjuvant radiotherapy and outcomes of women with stage III node-positive uterine cancer.


METHODS
All patients with surgically-staged stage III node-positive uterine cancer from the Surveillance Epidemiology and End Results database of the US National Cancer Institute from 1988 to 2001 were identified. Data were analyzed using Kaplan-Meier and logistic regression methods.


RESULTS
Of 943 women, the median age was 64 years (range: 28-93). 82.1%, 8.6%, and 6.8% were White, Black, and Asian respectively. The median number of removed nodes was 11. 54.9% had a single positive node and 45.1% had 2-5 positive nodes. Endometrioid, papillary serous, sarcomas, and clear cell carcinomas comprised of 69.7%, 16.3%, 9.9%, and 4.1% of histologies, respectively. 67.3% of the women underwent adjuvant radiotherapy with a 5-year disease-specific survival of 67.9% compared to 53.4% in those without radiotherapy (p<0.001). Adjuvant radiotherapy improved the survival from 54.4% to 74.3% (p<0.001) in those with a single positive node and from 52.4% to 59.7% (p=0.089) in those with 2-5 positive nodes. On multivariate analysis, older age, non-endometrioid histology, and lack of adjuvant radiotherapy remained as significant independent prognostic factors for worsened survival.


CONCLUSIONS
Our data suggest that adjuvant radiotherapy is associated with a significant survival benefit in women with single-positive node endometrioid uterine cancers. Prospective clinical trials are warranted to confirm these findings.
Schmid
Seraina
S
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, Box 1702, San Francisco, CA 94143-1702, USA.
Hsu
I-Chow
IC
Hu
Jessica M
JM
Sherman
Alexander E
AE
Osann
Kathryn
K
Kapp
Daniel S
DS
Chan
John K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012042:Registries; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery