Sophia Scharl1, Thomas Papathemelis2, Karin Kronberger3, Michael Gerken3, Anton Scharl2, Oliver Kölbl4, Monika Klinkhammer-Schalke3. 1. Klinik und Poliklinik für Strahlentherapie und RadioOnkologie, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Straße 22, 81675, Munich, Germany. sophiascharl@yahoo.de. 2. Frauenklinik, Klinikum St. Marien Amberg, Mariahilfbergweg 7, 92224, Amberg, Germany. 3. Tumorzentrum Regensburg, Institut für Qualitätssicherung und Versorgungsforschung der, Universität Regensburg, Am Biopark 9, 93053, Regensburg, Germany. 4. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93051, Regensburg, Germany.
Abstract
PURPOSE: Adjuvant treatment of high-grade endometrial cancer varies greatly due to the lack of definitive results from controlled randomized trials on the subject. In a retrospective study, we sought to investigate the influence of post-operative radio-, chemo, and radiochemotherapy on survival time and recurrence rates among high-grade endometrial cancer patients. METHODS: 284 high-grade endometrial cancer patients (FIGOI-III, or unknown classification) diagnosed between 1998 and 2015 were retrospectively analyzed. All patients underwent surgery. Overall survival (OS), recurrence-free survival (RFS), and recurrence rates were compared for post-operative treatment modalities of radiotherapy alone (RT), chemotherapy alone (CTX), radiochemotherapy (RCT), and observation (OBS). RESULTS: Post-operative RCT and RT resulted in a significantly improved 5-year OS of 94.1% (HR 0.104, CI 0.013-0.809) and 62.1% (HR 0.615, CI 0.390-0.969), respectively, compared to 43.6% for OBS. CTX did not significantly improve OS leading to a 5-year OS of 56.5% (HR 0.783, CI 0.224-2.740). 5-year recurrence rate was lowest for patients treated with RCT (5.3%). 5-year RFS was 94.1% for the RCT group and proved to be significantly superior to 58.8% for RT (HR 9.034, CI 1.184-68.948), 56% for CTX (HR 12.738, CI 1.337-121.346), and 37.4% for OBS (HR 16.407, CI 2.127-126.575), respectively. In comparison with OBS, RT alone resulted in a significant improvement in RFS (HR 0.551, CI 0.354-0.856). CONCLUSIONS: Our retrospective population-based study indicates a survival benefit from treating high-grade endometrial cancer with post-operative RCT. Randomized controlled trials are needed to minimize potential confounding parameters and further clarify the subject.
PURPOSE: Adjuvant treatment of high-grade endometrial cancer varies greatly due to the lack of definitive results from controlled randomized trials on the subject. In a retrospective study, we sought to investigate the influence of post-operative radio-, chemo, and radiochemotherapy on survival time and recurrence rates among high-grade endometrial cancerpatients. METHODS: 284 high-grade endometrial cancerpatients (FIGOI-III, or unknown classification) diagnosed between 1998 and 2015 were retrospectively analyzed. All patients underwent surgery. Overall survival (OS), recurrence-free survival (RFS), and recurrence rates were compared for post-operative treatment modalities of radiotherapy alone (RT), chemotherapy alone (CTX), radiochemotherapy (RCT), and observation (OBS). RESULTS: Post-operative RCT and RT resulted in a significantly improved 5-year OS of 94.1% (HR 0.104, CI 0.013-0.809) and 62.1% (HR 0.615, CI 0.390-0.969), respectively, compared to 43.6% for OBS. CTX did not significantly improve OS leading to a 5-year OS of 56.5% (HR 0.783, CI 0.224-2.740). 5-year recurrence rate was lowest for patients treated with RCT (5.3%). 5-year RFS was 94.1% for the RCT group and proved to be significantly superior to 58.8% for RT (HR 9.034, CI 1.184-68.948), 56% for CTX (HR 12.738, CI 1.337-121.346), and 37.4% for OBS (HR 16.407, CI 2.127-126.575), respectively. In comparison with OBS, RT alone resulted in a significant improvement in RFS (HR 0.551, CI 0.354-0.856). CONCLUSIONS: Our retrospective population-based study indicates a survival benefit from treating high-grade endometrial cancer with post-operative RCT. Randomized controlled trials are needed to minimize potential confounding parameters and further clarify the subject.
Authors: Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu Journal: Virchows Arch Date: 2021-02 Impact factor: 4.064
Authors: Sophia Scharl; Tim Sprötge; Michael Gerken; Anton Scharl; Olaf Ortmann; Oliver Kölbl; Monika Klinkhammer-Schalke; Thomas Papathemelis Journal: J Cancer Res Clin Oncol Date: 2022-10-14 Impact factor: 4.322
Authors: Sophia Scharl; Tim Sprötge; Michael Gerken; Anton Scharl; Atanas Ignatov; Elisabeth C Inwald; Olaf Ortmann; Oliver Kölbl; Monika Klinkhammer-Schalke; Thomas Papathemelis Journal: Arch Gynecol Obstet Date: 2021-07-05 Impact factor: 2.344