title: Concomitant postoperative radiation and chemotherapy following surgery was associated with improved overall survival in patients with FIGO stages III and IV endometrial cancer.
abstract: OBJECTIVE
  The aim of this study was to investigate the usefulness of concomitant postoperative radiation and chemotherapy in patients with the International Federation of Gynecology and Obstetrics (FIGO) stages III and IV endometrial cancer.
  
  
  METHODS
  A retrospective review at Shimane University and Ryukyu University, Japan, was performed of 76 patients with FIGO stages III and IV endometrial cancer. All patients had received a comprehensive staging procedure including hysterectomy, bilateral salpingo-oophorectomy, ± selective pelvic/aortic lymphadenectomy, surgical debulking, and treatment with adjuvant chemotherapy and/or radiotherapy.
  
  
  RESULTS
  Seventy-six patients with FIGO stages III and IV endometrial cancer were identified who received postoperative adjuvant therapies; 26% (N = 20) received radiotherapy alone, 40% (N = 30) chemotherapy alone, and 34% (N = 26) chemotherapy and radiotherapy. The median age was 55 years; 92% had the endometrioid type and 97% were optimally debulked. The median follow-up period was 54 (range 6-188) months. Combination therapy with chemotherapy and radiation correlated with longer overall survival compared with either chemotherapy alone (P = 0.0298) or chemotherapy alone + radiation alone (P = 0.0345). Combination therapy correlated with longer overall survival compared with radiation alone with marginal significance (P = 0.0521). No significant differences in the disease-free interval were seen among the combination therapy and chemotherapy alone or radiation alone groups.
  
  
  CONCLUSIONS
  Combined treatment with radiation and chemotherapy may improve overall survival in patients with FIGO stages III and IV endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, 89-1 Enyacho, Izumo, 693-8501, Japan. kn88@med.shimane-u.ac.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakayama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nagai
authors.forename: Masako
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Aoki
authors.forename: Khoji
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007564:Japan; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D010052:Ovariectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult