title: Acute and delayed complications from surgery and adjuvant radiotherapy in the treatment of high-risk endometrial cancer.
abstract: OBJECTIVE
  This retrospective study assessed the number and type of complications following surgery and adjuvant radiotherapy in the treatment of high-risk endometrial cancer.
  
  
  METHODS
  Endometrial cancer patients who received surgery and postoperative radiotherapy (pelvic radiotherapy and/or vaginal brachytherapy) from April 1997 until October 2010 were evaluated. Short-term (≤6 months) and long-term (>6 months) complications (e.g., genitourinary/gastrointestinal complications) were comprehensively reviewed.
  
  
  RESULTS
  We identified 109 high-risk endometrial cancer patients who completed adjuvant radiotherapy following either a total abdominal hysterectomy (TAH; n = 53) or minimally invasive hysterectomy (MIS; n = 56). The combined impact of surgery and radiotherapy on complication type did not reach statistical significance (p > 0.05). However, surgery type and the development of a complication were significantly related (p < 0.001). The MIS patients developed complications at a more accelerated rate compared to the TAH patients (21 vs. 45 months), although the incidence of toxicity of grade 3 or 4 was much higher in the TAH group.
  
  
  CONCLUSIONS
  The impact of MIS and adjuvant radiotherapy may have adversely affected the development of complications compared to TAH patients who received adjuvant radiotherapy, although higher-grade patient toxicity was more prevalent in the TAH group.
authors.affiliation: Gynecologic Oncology Associates, Newport Beach, CA 92663, USA.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Mendivil
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.forename: Craig
authors.initials: C
authors.lastname: Cox
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Abaid
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Lopez
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies