دورية أكاديمية
Management of stage II endometrial cancer and subsequent oncologic outcomes: a National Cancer Database study.
| العنوان: | Management of stage II endometrial cancer and subsequent oncologic outcomes: a National Cancer Database study. |
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| المؤلفون: | Vetter MH; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA. Monica.vetter@osumc.edu., Bixel K; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA., Felix AS; Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH, USA. |
| المصدر: | Journal of gynecologic oncology [J Gynecol Oncol] 2020 Nov; Vol. 31 (6), pp. e84. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Asian Society of Gynecologic Oncology Country of Publication: Korea (South) NLM ID: 101483150 Publication Model: Print Cited Medium: Internet ISSN: 2005-0399 (Electronic) Linking ISSN: 20050380 NLM ISO Abbreviation: J Gynecol Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: June 2011-: Seoul : Asian Society of Gynecologic Oncology : Taehan Puin Chongyang Hakhoe Original Publication: Seoul : Korean Society of Gynecologic Oncology and Colposcopy, June 2008- |
| مواضيع طبية MeSH: | Endometrial Neoplasms*/pathology, Aged ; Chemotherapy, Adjuvant ; Female ; Humans ; Hysterectomy ; Medicare ; Middle Aged ; Neoplasm Staging ; Radiotherapy, Adjuvant ; United States |
| مستخلص: | Objective: The management of stage II endometrial cancer (EC) is challenging due to the wide variation in surgical practice and adjuvant treatment recommendations. We sought to describe the treatment patterns for patients with stage II EC and to evaluate the association between surgical management and adjuvant therapy on survival outcomes in a large cohort of patients with stage II EC. Methods: Using data from the National Cancer Database, we identified 9,690 women with stage II EC. We used logistic regression to identify association of sociodemographic and tumor characteristics with surgery type and receipt of adjuvant therapy. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between adjuvant therapy, hysterectomy type, and overall survival. Results: Almost 11% of the cohort underwent radical hysterectomy; however, there was no difference in survival between surgical types even when adjusted for adjuvant therapy (HR=0.94; 95% CI=0.82-1.07). Compared to no adjuvant treatment, radiation only (HR=0.66; 95% CI=0.61-0.73) and combination radiation and chemotherapy (HR=0.53; 95% CI=0.45-0.62) were associated with lower risk of death. There was no survival benefit of chemotherapy alone even when separated by histologic subtype (HR range, 0.55-1.46). Conclusions: Women with stage II EC do not appear to benefit from routine radical hysterectomy though all patients appear to benefit from receipt of radiation therapy (RT), regardless of modality. Additionally, there may be an added survival benefit with the combination of computed tomography and RT in patients with non-endometrioid, high-risk histologies. Competing Interests: No potential conflict of interest relevant to this article was reported. (Copyright © 2020. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.) |
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| معلومات مُعتمدة: | K01CA21845701A1 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: Adjuvant Chemotherapy; Endometrial Cancer; Hysterectomy; Intracavity Radiotherapy; Radiation Therapy |
| تواريخ الأحداث: | Date Created: 20201020 Date Completed: 20210902 Latest Revision: 20210902 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC7593216 |
| DOI: | 10.3802/jgo.2020.31.e84 |
| PMID: | 33078593 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2005-0399 |
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| DOI: | 10.3802/jgo.2020.31.e84 |