International Journal of Hematology and Oncology 2019, Vol 29, Num 2 Page(s): 071-079
Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer

Mihriban KOCAK1, Makbule EREN1, Murat M. NAKI2, Atınç AKSU1, Hasniye CELIK2, Alper OZKAN1, Alparslan MAYADAGLI1, Orhan UNAL2

1Dr. Lutfi Kirdar Kartal Research and Training Hospital, Department of Radiology Oncology, Istanbul, TURKEY
2Dr. Lutfi Kirdar Kartal Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, TURKEY

Keywords: endometrial cancer stage IB; adjuvant radiotherapy; overall survival
Present study was designed to evaluate potential risks and benefits of adjuvant radiotherapy in selected patients with intermediate- risk endometrial cancer. A total of 100 patients with stage IB grade II endometrial cancer followed up in Radiation Oncology Clinic at Dr. Lutfi Kirdar Education and Research Hospital were evaluated retrospectively to determine the influence of postsurgical adjuvant radiotherapy on disease-free survival, local recurrences and locally-relaps free survival. Side effects related to adjuvant radiotherapy were also evaluated. Forty-seven (47%) patients were determined to undergo total abdominal hysterectomy + bilateral salphingo-oopherectomy and 53 (53%) patients, total abdominal hysterectomy + bilateral salphingo-oopherectomy + pelvic lymph node dissection. Postsurgical adjuvant radiotherapy was administered in 77 patients (77%), while the surgery was the sole medical intervention for 23 patients (23%). The median follow-up period was 40.5 months (range: 6-139) Five-year disease-free survival (96.6% vs. 80.5%; p< 0.01) and local control (98.6% vs. 80.5%; p<0.05) were better in patients who were administered postoperative radiotherapy compared to patients without postoperative radiotherapy.

In conclusion, while our results concerning homogenous sub-population of patients with stage IB grade II endometrial cancer seem to support the use of postoperative adjuvant radiotherapy, larger and more detailed prospective studies are required for determination of its exact prognostic value.