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Journals / Ege Tıp Dergisi / 2004 / Cilt: 43 - Sayı: 3

Postoperative radiotherapy in endometrial carcinoma: Analysis of treatment results and prognostic factors in 509 patients

Postoperatif radyoterapi uygulanan endometrium kanserli olgularda tedavi sonuçları ve prognostik faktörler: 509 olgunun değerlendirilmesi

Arif ARAS
Özlem DEMİR
Ayfer HAYDAROĞLU
Pages
169–174
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

Five-hundred-nine patients with endometrial carcinoma who received postoperative radiotherapy between January 1992-December 2001 were evaluated retrospectively to determine the overall disease-free and local-recurrence free survival rates and prognostic factors affecting survival.

📌 3 Key Takeaways

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Objective & Hypothesis:Five-hundred-nine patients with endometrial carcinoma who received postoperative radiotherapy between January 1992-December 2001 were evaluated retrospectively to determine the overall disease-free and local-recurrence free survival rates and prognostic factors affecting survival.
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Key Findings & Data:Mediag age was 58 (range: 31-83).
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Conclusion & Impact:The important prognostic factors influencing treatment results were stage, histologic grade, positive peritoneal cytology and lymphövasculer invasion.
🔬Design:Research Article
📍Scope:2001 Verileri
⚙️Variables:Seyir · Radyoterapi · Geriyedönük çalışma

Abstract

Five-hundred-nine patients with endometrial carcinoma who received postoperative radiotherapy between January 1992-December 2001 were evaluated retrospectively to determine the overall disease-free and local-recurrence free survival rates and prognostic factors affecting survival. Mediag age was 58 (range: 31-83). Histologically 88.0% were adenocarcinoma, 6.1% adenosquamous carcinoma, 4.3% clear-cell carcinoma and 1.6% serous papillary carcinoma. The distribution by stages were: 65.1% Stage I, 17.7% Stage II, 14.6% Stage III, 2.8% Stage IVA. All patients received median 54 Gy external radiotherapy with 1.8-2.0 Gy daily fractions. Intracavitary brachytherapy was applied to 463 cases. Median follow-up time was 68 months (range: 6-141 months). Survival analysis was performed using the Kaplan-Meier method. Log-rank test was used for univariate analysis and Cox regression test was used for multivariate analysis. Five-year overall, disease-free and local recurrence-free survival rates were 80.5%, 85.1% and 91.2% respectively. According to univariate analysis prognostic factors influencing local control were histology (p=0.001),stage (p<0.001), histologic grade (p=0.03), positive peritoneal cytology (p<0.001) while the factors affecting overall survival were stage (p<0.001), histologic grade (p=0.014), histology (p<0.001), myometrial invasion (p=0.004), lymphovascular invasion (p=0.004), positive peritoneal cytology (p<0.001). When multivariant analyses were done only histology (p=0.004) and stage (p<0.001) appeared to be prognostic factors, whereas no prognostic factors for local control appeared in multivariant analyses.Postoperative radiotherapy is a highly effective adjuvant treatment providing high Içcoregional control rates. The important prognostic factors influencing treatment results were stage, histologic grade, positive peritoneal cytology and lymphövasculer invasion.

Özet

Ocak 1992-Aralık 2001 tarihleri arasında postopratif radyoterapi uygulanan 509 olgu genel sağkalım,hastalıksız sağkalım ve lokal kontrol oranları ve bu sonuçları etkileyen prosnostik faktörler açısından geriye dönük olarak değerlendirilmiştir.Olguların medyan yaşı 58(aralık:31-83) olup histolojik olarak %88.0'ı adenokarsinom,%6.1'i adenoskuamöz karsinom.%4.3'ü clear cell karsinom,%1.6'ı papillar seröz karsinomdur.Evrelere göre dağılım %65.1 evre I,%17.7 evre II ,%14.6 evre III,%2.8 evre IVa şeklindedir.Tün olgulara 1.8-2 Gy'lik günlük fraksiyonlarda medyan 54 Gy eksternal radyoterapi (RT)sonrasıbrakiterapi uygulanmıştır. Medyan takip süresi 68 ay (aralık 6-141)'dir. Sağkalım analizlerinde Kaplan-Meier yöntemi kullanılmış, tekdeğişkenli analizler için Log-rank, çok değişkenli analizler için Cox regresyon testi yapılmıştır. Beş yıllık genel, hastalıksız ve lokal nüksüz sağkalım oranları sırasıyla %80.5, %85.1 ve %91.2' dir. Tek değişkenli analizlerde lokal kontrolü etkileyen faktörlerin histoloji (p=0.001), evre (p<0.001), histolojik derece (p=0.03), pozitif peritoneal sitoloji (p<0.001) ile ilişkili olduğu saptanmıştır. Aynı değerlendir¬me genel sağkalım için tekrarlandığında evre (p<0.001), histolojik derece (p=0.014), histoloji (p<0.001), myometrial invazyon (p=0.004), lenfovasküler invazyon (p=0.004), pozitif peritoneal sitoloji (p<0.001)'nin sağkalımı etkileyen faktörler olduğu belirlenmiştir. Çok değişkenli analizlerde histolojik tip (p=0.04) ve evre (p<0.001) sağkalımı belirleyen faktörler olarak belirlenmiş, ancak lokal kontrol için prognostik bir faktör saptanmamıştır. Endomefrium kanserinde postoperatif radyoterapi yüksek lokal kontrol oranları nedeniyle tercih edilen adjuvan tedavi yöntemidir. Tedavi sonuçlarını etkileyen önemli prognostik faktörler ise evre, histolojik derece, pozitif peritoneal sitoloji ve lenfovasküler invazyon olarak belirlenmiştir.

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Cite This Article

ARAS, A., DEMİR, Ö., HAYDAROĞLU, A. (2004). Postoperative radiotherapy in endometrial carcinoma: Analysis of treatment results and prognostic factors in 509 patients. Ege Tıp Dergisi, Cilt: 43 - Sayı: 3, 169–174. https://ajindex.com/articles/222968

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