PURPOSE: In 2000, the results of the multicenter Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial were published. This trial included 714 Stage I endometrial carcinoma patients randomly assigned topostoperative pelvic radiotherapy (RT) or no further treatment, excluding those with Stage IC, Grade 3, or Stage IB, Grade 1 lesions. Radiotherapy significantly decreased the risk of locoregional recurrence (4% vs. 14%), without affecting overall survival. In this report the long-term outcome and results with central pathology review are presented. METHODS AND MATERIALS: The slides of 569 patients (80%) could be obtained for pathology review. Median follow-up for patients alive was 97 months. Analysis was done according to the intention-to-treat principle. The primary study endpoints were locoregional recurrence and death. RESULTS: Ten-year locoregional relapse rates were 5% (RT) and 14% (controls; p < 0.0001), and 10-year overall survival was 66% and 73%, respectively (p = 0.09). Endometrial cancer related death rates were 11% (RT) and 9% (controls; p = 0.47). Pathology review showed a substantial shift from Grade 2 to Grade 1, but no significant difference for Grade 3. When cases diagnosed at review as Grade 1 with superficial myometrial invasion were excluded from the analysis, the results remained essentially the same, with 10-year locoregional recurrence rates of 5% (RT) and 17% (controls; p < 0.0001). CONCLUSIONS: In view of the significant locoregional control benefit, radiotherapy remains indicated in Stage I endometrial carcinoma patients with high-risk features for locoregional relapse.
RCT Entities:
PURPOSE: In 2000, the results of the multicenter Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial were published. This trial included 714 Stage I endometrial carcinomapatients randomly assigned to postoperative pelvic radiotherapy (RT) or no further treatment, excluding those with Stage IC, Grade 3, or Stage IB, Grade 1 lesions. Radiotherapy significantly decreased the risk of locoregional recurrence (4% vs. 14%), without affecting overall survival. In this report the long-term outcome and results with central pathology review are presented. METHODS AND MATERIALS: The slides of 569 patients (80%) could be obtained for pathology review. Median follow-up for patients alive was 97 months. Analysis was done according to the intention-to-treat principle. The primary study endpoints were locoregional recurrence and death. RESULTS: Ten-year locoregional relapse rates were 5% (RT) and 14% (controls; p < 0.0001), and 10-year overall survival was 66% and 73%, respectively (p = 0.09). Endometrial cancer related death rates were 11% (RT) and 9% (controls; p = 0.47). Pathology review showed a substantial shift from Grade 2 to Grade 1, but no significant difference for Grade 3. When cases diagnosed at review as Grade 1 with superficial myometrial invasion were excluded from the analysis, the results remained essentially the same, with 10-year locoregional recurrence rates of 5% (RT) and 17% (controls; p < 0.0001). CONCLUSIONS: In view of the significant locoregional control benefit, radiotherapy remains indicated in Stage I endometrial carcinomapatients with high-risk features for locoregional relapse.
Authors: Igor Sirák; Marian Kacerovský; Miroslav Hodek; Jiří Petera; Jiří Spaček; Linda Kašaová; Zdeněk Zoul; Milan Vošmik Journal: Rep Pract Oncol Radiother Date: 2011-12-15
Authors: Karen M Gil; Stephanie L Pugh; Ann H Klopp; Anamaria R Yeung; Lari Wenzel; Shannon N Westin; David K Gaffney; William Small; Spencer Thompson; Desiree E Doncals; Guilherme H C Cantuaria; Brian P Yaremko; Amy Chang; Vijayananda Kundapur; Dasarahally S Mohan; Michael L Haas; Yong Bae Kim; Catherine L Ferguson; Snehal Deshmukh; Lisa A Kachnic; Deborah W Bruner Journal: Gynecol Oncol Date: 2019-05-16 Impact factor: 5.482
Authors: Jamie N Bakkum-Gamez; Andrea Mariani; Sean C Dowdy; Amy L Weaver; Michaela E McGree; Janice R Martin; Gary L Keeney; Aminah Jatoi; Bobbie S Gostout; Karl C Podratz Journal: Gynecol Oncol Date: 2014-01-14 Impact factor: 5.482
Authors: Melissa S Y Thong; Floortje Mols; Jan-Willem W Coebergh; Jan A Roukema; Lonneke V van de Poll-Franse Journal: J Cancer Surviv Date: 2009-06-26 Impact factor: 4.442