title: Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma.
abstract: OBJECTIVE
  The aim of this study was to describe the impact of postoperative adjuvant treatment modalities and identify risk factors associated with recurrence and survival rates in women diagnosed with early stage type II endometrial cancer and carcinosarcoma.
  
  
  METHODS
  In this retrospective study, patients diagnosed with early stage (stages I-II) carcinosarcoma and type II endometrial cancer were reviewed. All women underwent comprehensive surgical staging. Postoperative treatment options of chemotherapy (CT), radiotherapy (RT), observation (OBS) and chemotherapy-radiotherapy (CT-RT) combination were compared in terms of recurrence and survival outcome.
  
  
  RESULTS
  In CT-RT treatment arm, recurrence rate was found as 12.5% and this result is significantly lower than the other treatment approaches (P = 0.01 CT alone: 33.3%, RT alone: 26.7%, OBS: 62.5%). Three-year disease free survival(DFS) rate and overall survival (OS) rate were statistically higher for the group of women treated with combination of CT-RT (92-95%) compared to the women treated with RT alone (65-72%), treated with CT alone (67-74%) and women who received no adjuvant therapy (38-45%). The multivariate analysis revealed that carcinosarcoma histology was associated with shortened DFS and OS (P = 0.001, P = 0.002). On the other hand, being at stage Ia (P = 0.01, P = 0.04) and receiving adjuvant treatment of CT-RT combination (P = 0.005, P = 0.002) appeared to lead to increased DFS and OS rates.
  
  
  CONCLUSIONS
  We identified that a combination treatment of chemotherapy and radiotherapy is superior compared to other postoperative adjuvant treatment approaches concerning PFS, OS and recurrence rates in stages I-II of type II endometrial cancers and uterine carcinosarcoma.
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Hamdullah
authors.initials: H
authors.lastname: Sozen
authors.affiliation: Faculty of Medicine, Department Of Medical Oncology, Istanbul University, Turkey, Istanbul.
authors.forename: Rumeysa
authors.initials: R
authors.lastname: Çiftçi
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Dogan
authors.initials: D
authors.lastname: Vatansever
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Samet
authors.initials: S
authors.lastname: Topuz
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Ahmet Cem
authors.initials: AC
authors.lastname: Iyibozkurt
authors.affiliation: Faculty of Medicine, Department Of Medical Oncology, Istanbul University, Turkey, Istanbul.
authors.forename: Hamza Ugur
authors.initials: HU
authors.lastname: Bozbey
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Cenk
authors.initials: C
authors.lastname: Yaşa
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Halime
authors.initials: H
authors.lastname: Çali
authors.affiliation: Faculty of Medicine, Department Of Pathology, Istanbul University, Turkey, Istanbul.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Yavuz
authors.affiliation: Faculty of Medicine, Department Of Radiation Oncology, Istanbul University, Turkey, Istanbul.
authors.forename: Seden
authors.initials: S
authors.lastname: Kucucuk
authors.affiliation: Faculty of Medicine, Department Of Medical Oncology, Istanbul University, Turkey, Istanbul.
authors.forename: Adnan
authors.initials: A
authors.lastname: Aydiner
authors.affiliation: Faculty of Medicine, Department Of Obstetrics and Gynecology, Istanbul University, Turkey, Istanbul.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Salihoglu
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000628:therapy*; D000368:Aged; D001011:Aorta; D002296:Carcinosarcoma / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D018193:Neoplasms, Complex and Mixed / Q000473:pathology / Q000628:therapy*; D010052:Ovariectomy; D010388:Pelvis; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D058994:Salpingectomy; D015996:Survival Rate
keywords: chemotherapy; endometrial carcinosarcoma; radiotherapy; type II endometrial cancer