Conservative management of Stage I endometrial carcinoma after surgical staging

J. Straughn, Warner K. Huh, F. Kelly, Charles A. Leath, Marc J. Kleinberg, Johnny Hyde, T. Numnum, Yuting Zhang, Seng Jaw Soong, J. Austin, Edward E. Partridge, Larry Kilgore, Ronald D. Alvarez

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Abstract

Objective. The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging. Methods. A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998. A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium. A total of 670 of 864 patients (78%) underwent comprehensive surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and peritoneal cytology. After 57 patients with high-risk histologic subtypes were excluded, 613 patients remained for analysis. Results. A total of 321 of 325 Stage IB patients (99%) did not receive adjuvant radiation. Fifteen of 321 patients (5%) recurred; 9 recurred in the pelvis or vagina. All 9 local recurrences were salvaged with whole pelvic radiation (XRT) and brachytherapy (BT). Seventy-seven patients were diagnosed with Stage IC disease; 53 (69%) received no adjuvant therapy. Four patients (8%) recurred, of which 2 recurred in the vagina. Three of 4 patients (75%) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy. For all Stage I patients, the 5-year disease-free survival was 93% and the 5-year overall survival was 98%. Conclusions. Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy. Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalGynecologic oncology
Volume84
Issue number2
DOIs
StatePublished - Jan 1 2002

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Endometrial Neoplasms
Brachytherapy
Vagina
Radiation
Endometrium
Recurrence
Conservative Treatment
Adenocarcinoma
Ovariectomy
Lymph Node Excision
Hysterectomy
Pelvis
Disease-Free Survival
Cell Biology
Radiotherapy
Databases
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Straughn, J., Huh, W. K., Kelly, F., Leath, C. A., Kleinberg, M. J., Hyde, J., ... Alvarez, R. D. (2002). Conservative management of Stage I endometrial carcinoma after surgical staging. Gynecologic oncology, 84(2), 194-200. https://doi.org/10.1006/gyno.2001.6494

Conservative management of Stage I endometrial carcinoma after surgical staging. / Straughn, J.; Huh, Warner K.; Kelly, F.; Leath, Charles A.; Kleinberg, Marc J.; Hyde, Johnny; Numnum, T.; Zhang, Yuting; Soong, Seng Jaw; Austin, J.; Partridge, Edward E.; Kilgore, Larry; Alvarez, Ronald D.

In: Gynecologic oncology, Vol. 84, No. 2, 01.01.2002, p. 194-200.

Research output: Contribution to journalArticle

Straughn, J, Huh, WK, Kelly, F, Leath, CA, Kleinberg, MJ, Hyde, J, Numnum, T, Zhang, Y, Soong, SJ, Austin, J, Partridge, EE, Kilgore, L & Alvarez, RD 2002, 'Conservative management of Stage I endometrial carcinoma after surgical staging', Gynecologic oncology, vol. 84, no. 2, pp. 194-200. https://doi.org/10.1006/gyno.2001.6494
Straughn J, Huh WK, Kelly F, Leath CA, Kleinberg MJ, Hyde J et al. Conservative management of Stage I endometrial carcinoma after surgical staging. Gynecologic oncology. 2002 Jan 1;84(2):194-200. https://doi.org/10.1006/gyno.2001.6494
Straughn, J. ; Huh, Warner K. ; Kelly, F. ; Leath, Charles A. ; Kleinberg, Marc J. ; Hyde, Johnny ; Numnum, T. ; Zhang, Yuting ; Soong, Seng Jaw ; Austin, J. ; Partridge, Edward E. ; Kilgore, Larry ; Alvarez, Ronald D. / Conservative management of Stage I endometrial carcinoma after surgical staging. In: Gynecologic oncology. 2002 ; Vol. 84, No. 2. pp. 194-200.
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abstract = "Objective. The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging. Methods. A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998. A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium. A total of 670 of 864 patients (78{\%}) underwent comprehensive surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and peritoneal cytology. After 57 patients with high-risk histologic subtypes were excluded, 613 patients remained for analysis. Results. A total of 321 of 325 Stage IB patients (99{\%}) did not receive adjuvant radiation. Fifteen of 321 patients (5{\%}) recurred; 9 recurred in the pelvis or vagina. All 9 local recurrences were salvaged with whole pelvic radiation (XRT) and brachytherapy (BT). Seventy-seven patients were diagnosed with Stage IC disease; 53 (69{\%}) received no adjuvant therapy. Four patients (8{\%}) recurred, of which 2 recurred in the vagina. Three of 4 patients (75{\%}) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy. For all Stage I patients, the 5-year disease-free survival was 93{\%} and the 5-year overall survival was 98{\%}. Conclusions. Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy. Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy.",
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AU - Hyde, Johnny

AU - Numnum, T.

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AU - Soong, Seng Jaw

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N2 - Objective. The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging. Methods. A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998. A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium. A total of 670 of 864 patients (78%) underwent comprehensive surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and peritoneal cytology. After 57 patients with high-risk histologic subtypes were excluded, 613 patients remained for analysis. Results. A total of 321 of 325 Stage IB patients (99%) did not receive adjuvant radiation. Fifteen of 321 patients (5%) recurred; 9 recurred in the pelvis or vagina. All 9 local recurrences were salvaged with whole pelvic radiation (XRT) and brachytherapy (BT). Seventy-seven patients were diagnosed with Stage IC disease; 53 (69%) received no adjuvant therapy. Four patients (8%) recurred, of which 2 recurred in the vagina. Three of 4 patients (75%) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy. For all Stage I patients, the 5-year disease-free survival was 93% and the 5-year overall survival was 98%. Conclusions. Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy. Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy.

AB - Objective. The aim of this study was to determine the outcomes of Stage I endometrial carcinoma patients who are managed without adjuvant radiation after comprehensive surgical staging. Methods. A computerized hospital database identified women diagnosed with adenocarcinoma of the endometrium from 1993 to 1998. A chart review identified 864 women as having primary surgery for adenocarcinoma of the endometrium. A total of 670 of 864 patients (78%) underwent comprehensive surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, pelvic/para-aortic lymphadenectomy, and peritoneal cytology. After 57 patients with high-risk histologic subtypes were excluded, 613 patients remained for analysis. Results. A total of 321 of 325 Stage IB patients (99%) did not receive adjuvant radiation. Fifteen of 321 patients (5%) recurred; 9 recurred in the pelvis or vagina. All 9 local recurrences were salvaged with whole pelvic radiation (XRT) and brachytherapy (BT). Seventy-seven patients were diagnosed with Stage IC disease; 53 (69%) received no adjuvant therapy. Four patients (8%) recurred, of which 2 recurred in the vagina. Three of 4 patients (75%) were salvaged, 2 with XRT/BT and 1 with surgery and chemotherapy. For all Stage I patients, the 5-year disease-free survival was 93% and the 5-year overall survival was 98%. Conclusions. Surgically staged patients with endometrial carcinoma confined to the uterine corpus have a small risk of recurrence and the majority of these recurrences can be salvaged with radiation therapy. Conservative management of Stage I endometrial carcinoma patients is an effective treatment strategy.

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