FIGO Stage IIIC Endometrial Carcinoma with Metastases Confined to Pelvic Lymph Nodes: Analysis of Treatment Outcomes, Prognostic Variables, and Failure Patterns Following Adjuvant Radiation Therapy

1999 ◽  
Vol 75 (2) ◽  
pp. 211-214 ◽  
Author(s):  
George Nelson ◽  
Marcus Randall ◽  
Gregory Sutton ◽  
David Moore ◽  
Jean Hurteau ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Lymph Nodes ◽  
Endometrial Carcinoma ◽  
Treatment Outcomes ◽  
Figo Stage ◽  
Adjuvant Radiation ◽  
Stage Iiic ◽  
Prognostic Variables ◽  
Adjuvant Radiation Therapy ◽  
Failure Patterns

FIGO stage IIIC endometrial carcinoma: Resection of macroscopic nodal disease and other determinants of survival

2003 ◽  
Vol 13 (5) ◽  
pp. 664-672 ◽  
Author(s):  
R. E. Bristow ◽  
M. L. Zahurak ◽  
C. J. Alexander ◽  
R. C. Zellars ◽  
F. J. Montz
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Endometrial Carcinoma ◽  
Figo Stage ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Nodal Disease ◽  
Stage Iiic

The objective of this study was to evaluate the potential survival benefit of debulking macroscopic adenopathy and other clinical prognostic factors among patients with node-positive endometrial carcinoma. Demographic, operative, pathologic, & follow-up data were abstracted retrospectively for 41 eligible patients with FIGO stage IIIC endometrial cancer. Survival curves were generated using the Kaplan-Meier method and statistical comparisons were performed using the log rank test, logistic regression analysis, and the Cox proportional hazards regression model. All patients had positive pelvic lymph nodes and 20 patients (48.8%) had positive para-aortic lymph nodes. Postoperatively, all patients received whole pelvic radiation therapy, 17 received extended-field radiation therapy, and 15 patients received chemotherapy. The median disease-specific survival (DSS) time for all patients was 30.6 months (median follow-up 34. 0 months). Patients with completely resected macroscopic lymphadenopathy had a significantly longer median DSS time (37.5 months), compared to patients left with gross residual nodal disease (8.8 months, P = 0.006). On multivariate analysis, independent predictors of DSS were gross residual nodal disease (HR 7.96, 95% CI 2.54–24.97, P < 0. 001), age ≥ 65 years (HR 6.22, 95% CI 2.05–18.87, P = 0.001), and the administration of adjuvant chemotherapy (HR 0.22, 95% CI 0.07–0.76, P = 0.016). We conclude that in patients with stage IIIC endometrial carcinoma, complete resection of macroscopic nodal disease and the administration of adjuvant chemotherapy, in addition to directed radiation therapy, are associated with improved survival.

Value of adjuvant radiation therapy in breast cancer patients with one to three positive lymph nodes undergoing a modified radical mastectomy and systemic therapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 507-507 ◽  
Author(s):  
S. Dawood ◽  
A. M. Gonzalez-Angulo ◽  
W. Woodward ◽  
F. Meric-Bernstam ◽  
K. Hunt ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Lymph Nodes ◽  
Systemic Therapy ◽  
Distant Recurrence ◽  
Axillary Lymph Nodes ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Adjuvant Radiation Therapy ◽  
Increased Risk ◽  
Segmental Mastectomy

507 Background: Whether adjuvant radiation therapy should be utilized for patients (pts) with early stage breast cancer with up to 3 positive axillary lymph nodes treated with mastectomy and systemic therapy is controversial. This retrospective study was performed to determine if adjuvant radiation therapy had an impact on survival for this cohort of pts. Methods: 4240 pts with T1–2N0–1 breast cancers, diagnosed between 1980–2007, who underwent either mastectomy without adjuvant radiation therapy or segmental mastectomy with adjuvant radiation therapy were identified. All pts received systemic treatment. Women with >3 positive axillary lymph nodes were excluded. Overall (OS) and distant disease free survival (DDFS) were estimated using the Kaplan-Meir product method. Cox proportional hazards were used to determine associations between OS/DDFS and type of surgery after controlling for pt and disease characteristics. Results: 1336 (18.8%) had T1N0 disease, 1114 (26.27%) had T2N0 disease, 989 (23.33%) had T1N1 disease and 801 (18.89%) had T2N1 disease. Median follow-up was 54 months.5- year DDFS among women who underwent mastectomy and segmental mastectomy was 81% (95% 78%-83%) and 86% (95% CI 84%-87%), respectively (p < 0.0001). In the Cox analysis, pts who had mastectomy without radiation had a significantly increased risk of distant recurrence (HR= 1.39, 95% CI 1.14–1.70, p= 0.0013) than pts treated with segmental mastectomy and radiation. When looking at subgroups, no significant difference in DDFS was observed between the two groups in pts with lymph node negative disease. However, for pts with 1–3 positive lymph nodes, pts treated with mastectomy without radiation had significantly increased risk of distant recurrence compared to pts treated with segmental mastectomy with radiation (HR=1.614, 95% CI 1.198–2.177, p= 0.002). This difference was most pronounce in the subset of patients with T2N1 disease (HR= 1.794, 95% CI 1.220–2.637, p=0.003). Similar trends were observed for OS. Conclusions: This study provides provocative evidence for benefit of radiation therapy among pts with 1–3 positive axillary lymph nodes who are treated with surgery and systemic therapy. No significant financial relationships to disclose.

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