title: Evaluation of treatment outcomes of early-stage endometrial cancer radiotherapy: a single center experience.
abstract: BACKGROUND
  Postoperative adjuvant radiotherapy (RT) in the management of early stage endometrial cancer (EC) is still controversial. Here we report our institutional experience with patients who received postoperative RT for stage I-II EC over a period of 35 years and assess potential predictors of local recurrence (LR), distant metastasis (DM), and overall survival (OS).
  
  
  METHODS
  A total of 188 patients undergoing postoperative RT for stage IA-II EC between 1977 and 2012 were evaluated. Some 96 received median 46 Gy whole pelvic radiotherapy (WPRT) (range: 40-60 Gy), 37 were given WPRT with vaginal cuff therapy (VCT), and 55 received only VCT either with brachytherapy (BT) or stereotactic body radiotherapy (SBRT). Chemotherapy was given to 5 patients with uterine papillary serous carcinoma (UPSC). Logistic regression analysis was used to assess the effect of clinicopathological factors on LR, DM, and OS.
  
  
  RESULTS
  Median follow-up time was 11 years (range: 1-35 years). At the time of analysis, 34 patients were not alive. Of the 15 patients with LR, 7 (46.7%) recurred in the vaginal stump, 5 (33.3%) in the pelvic region, and 3 (20%) in the paraaortic nodal region, while 12 had distant metastasis. UPSC histology (p=0.027), sole VCT (p=0.041), high histologic grade (p=0.034), and age≥71 (p=0.04) were poor prognostic factors on univariate analysis.
  
  
  CONCLUSIONS
  In our patients receiving radiotherapy for early-stage EC, grade III disease and age≥71 were associated with shorter OS whereas UPSC histology was an independent predictor for both LR and DM.
authors.affiliation: Department of Radiation Oncology, Division of Epidemiology, Gulhane Military Medical Academy, Ankara, Turkey E-mail : drs.demiral@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Demiral
authors.forename: M
authors.initials: M
authors.lastname: Beyzadeoglu
authors.forename: O
authors.initials: O
authors.lastname: Sager
authors.forename: F
authors.initials: F
authors.lastname: Dincoglan
authors.forename: B
authors.initials: B
authors.lastname: Uysal
authors.forename: H
authors.initials: H
authors.lastname: Gamsiz
authors.forename: M
authors.initials: M
authors.lastname: Akin
authors.forename: T
authors.initials: T
authors.lastname: Turker
authors.forename: B
authors.initials: B
authors.lastname: Dirican
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000150:complications / Q000188:drug therapy*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome