Health related quality of life and symptoms after pelvic lymphadenectomy or radiotherapy vs. no adjuvant regional treatment in early-stage endometrial carcinoma: a large population-based study.
OBJECTIVE
Routine lymphadenectomy (LA) in early stage endometrial cancer does not improve survival. However, in the absence of lymph node metastasis, radiotherapy (RT) could be withheld and hence could result in less morbidity. Our aim was to evaluate health related quality of life (HRQL) in endometrial cancer survivors that received routine pelvic LA without RT compared to no LA, but RT in the presence of risk factors.


METHODS
Stage I-II endometrial cancer survivors diagnosed between 1999 and 2007 were selected from the Eindhoven Cancer Registry. Survivors completed the SF-36 and the EORTC-QLQ-EN24. ANCOVA and multiple linear regression analyses were applied.


RESULTS
742 (77%) of the endometrial cancer survivors returned a completed questionnaire. 377 (51%) had received no LA nor RT (LA-RT-), 198 (27%) had received LA+RT-, 153 (21%) LA-RT+ and 14 patients (2%) had received both. LA+ women reported as higher lymphedema symptom scores (25 vs. 20, p=0.04). Women who were treated with RT reported higher gastrointestinal symptom scores vs. those who did not (23 vs. 16, p=0.04). HRQL scales were comparable between all four treatment groups.


CONCLUSIONS
Despite distinct symptom patterns among women who received LA or RT, no clinically relevant differences in HRQL were observed when compared to women not receiving adjuvant therapy. Using LA to tailor adjuvant pelvic radiotherapy and prevent over-treatment in low-risk patients cannot be recommended.
Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, The Netherlands. l.vd.poll@ikz.nl
Lonneke V
LV
van de Poll-Franse
Johanna M A
JM
Pijnenborg
Dorry
D
Boll
M Caroline
MC
Vos
Hetty
H
van den Berg
Marnix L M
ML
Lybeert
Karin
K
de Winter
Roy F P M
RF
Kruitwagen
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis / Q000601:surgery; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires