(S030) Impact of Adjuvant Radiation Therapy on Overall Survival of Stage I Endometrial Cancer in a Large Hospital-Based Cohort

Publication
Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

Using a large hospital-based dataset, adjuvant RT was associated with improved OS for patients with stage IB endometrial adenocarcinoma.

Andrew T. Wong, MD, Joseph Weiner, MD, Joseph Safdieh, MD, David Schwartz, MD, David Schreiber, MD; Department of Veterans Affairs, NY Harbor Healthcare

BACKGROUND: Two randomized trials have demonstrated a local control advantage in the absence of a survival advantage for the addition of adjuvant radiation therapy (RT) in patients with stage I endometrial adenocarcinoma after hysterectomy. This study analyzed the National Cancer Data Base (NCDB) to evaluate the impact of adjuvant RT on overall survival (OS) of patients with stage I endometrial adenocarcinoma.

METHODS: Patients with endometrial adenocarcinoma who underwent total abdominal hysterectomy/bilateral salpingo-oophorectomy between 2004 and 2011 were queried. Only those with American Joint Committee on Cancer (AJCC) stage pT1N0M0 were included. Patients surviving < 4 months were also excluded, to account for immortal time bias. Adjuvant RT included external beam RT, brachytherapy, or external RT + brachytherapy. OS with or without RT was analyzed using the Kaplan-Meier method. Multivariate Cox regression analysis was performed to assess the impact of covariates on OS.

RESULTS: There were 61,697 patients included. Median follow-up was 48.7 months, and the median number of lymph nodes removed was 12. Most women (83%) did not receive adjuvant RT. Those receiving RT were more likely to be older (median age: 64 yr vs 61 yr; P < .001) and to have higher stage/grade disease (P < .001). The effect of RT was highly dependent on the stage and grade. For patients with stage IA endometrial cancer, grades 1–3, there were no significant differences in 5-year OS with or without RT. However, for those with stage IB disease, adjuvant RT was associated with improved OS. The 5-year OS rates with and without RT were 93.2% vs 88.8% (P < .001), 85.4% vs 82% (P < .001), and 74.8% vs 69.6% (P < .001) for stage IB grade 1, grade 2, and grade 3, respectively. On multivariate analysis, use of adjuvant RT was associated with improved OS (hazard ratio, 0.90 [95% CI, 0.84–0.97]; P = .003).

CONCLUSION: Using a large hospital-based dataset, adjuvant RT was associated with improved OS for patients with stage IB endometrial adenocarcinoma.

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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