title: Adjuvant radiation therapy is associated with improved pelvic control and overall survival in FIGO IB endometrial carcinoma with high grade histology.
abstract: OBJECTIVE
  High grade histologies of endometrial carcinomas portend a worse prognosis. Previous randomized, prospective studies examining the role of radiation have excluded endometrial cancer patients with FIGO IB with high risk histologies (clear cell, papillary serous, and Grade 3 endometrioid adenocarcinoma).
  
  
  METHODS
  We retrospectively identified 51 patients who underwent a hysterectomy for a FIGO IB endometrial carcinoma with clear cell, papillary serous or Grade 3 endometrioid adenocarcinoma histology. Adjuvant radiation therapy was delivered in 44 of 51 patients (86%). We assessed pelvic control, vaginal control, and overall survival using Kaplan Meier estimate and the log rank test. We completed univariate analysis.
  
  
  RESULTS
  The 5-year vaginal control rate in patients without and with adjuvant radiation therapy was 67% and 93.3%, respectively (p=0.0066). At 5-years, the pelvic control rate in patients without and with adjuvant radiation therapy was 0% and 81.5%, respectively (p=0.0003). At 5-years, the overall survival was 80% in patients who had adjuvant radiation compared to 21.4% in patients who did not have adjuvant radiation (p=0.0026). Radiation therapy was the only studied variable that was associated with pelvic control. Radiation therapy, advanced age and pelvic lymphadenectomy were associated with overall survival.
  
  
  CONCLUSIONS
  Adjuvant radiation therapy in patients with FIGO IB endometrial carcinoma with high risk histologies was associated with improved vaginal control, pelvic control, and overall survival.
authors.affiliation: Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, United States.
authors.forename: David
authors.initials: D
authors.lastname: Ly
authors.affiliation: Department of Gynecologic Oncology, Huntsman Cancer Hospital, Salt Lake City, UT, United States.
authors.forename: Pat Andrew
authors.initials: PA
authors.lastname: Soisson
authors.affiliation: Department of Gynecologic Oncology, Huntsman Cancer Hospital, Salt Lake City, UT, United States.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Dodson
authors.affiliation: Radiation Oncology, Intermountain Medical Center, Salt Lake City, UT, United States.
authors.forename: William T
authors.initials: WT
authors.lastname: Sause
authors.affiliation: Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, United States. Electronic address: david.gaffney@hci.utah.edu.
authors.forename: David K
authors.initials: DK
authors.lastname: Gaffney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Brachytherapy; Clear cell; Endometrial; FIGO IB; Papillary serous; Radiation