The efficacy of adjuvant chemotherapy on the survival of early stage endometrial cancer

• Published in: European journal of obstetrics & gynecology and reproductive biology 2023-08, Vol.287, p.155-160
• Main Authors: Yoneoka, Yutaka, Amano, Tsukuru, Tsuji, Shunichiro, Uno, Masaya, Ishikawa, Mitsuya, Kato, Tomoyasu, Murakami, Takashi
• Format: Article
• Language: English
• Subjects: Adjuvant; Chemotherapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Endometrial neoplasms; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Humans; Middle Aged; Neoplasm Staging; Radiotherapy, Adjuvant; Retrospective Studies
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2023.06.004

No consensus exists on the adjuvant chemotherapy for the International Federation of Gynecology and Obstetrics (FIGO) Stage I-II endometrial cancer with risk factors for recurrence. This study evaluated adjuvant chemotherapy's efficacy in improving these patients' survival. We conducted a retrospective chart review of patients with FIGO Stage I-II endometrial cancer with recurrence risk factors. The patients received no adjuvant therapy at the National Cancer Center Hospital (NCCH) but received platinum-based chemotherapy at Shiga University of Medical Science (SUMS). Six hundred thirty-eight patients with endometrial cancer were identified. Of these, 118 met the inclusion criteria, 321 were excluded from NCCH, while 49 met the inclusion criteria, and 150 were excluded from SUMS. Multivariate analyses of age, surgery, para-aortic lymphadenectomy, omentectomy, histological type, myometrial invasion, cervical stromal invasion, and adjuvant therapy revealed that in patients aged > 60 years with type II histology, the outer half of myometrial invasion, cervical stromal invasion, and positive peritoneal cytology had significantly worse recurrence-free survival (RFS) rates, and patients aged > 60 years with type II histology, outer half of myometrial invasion, and positive peritoneal cytology had significantly worse overall survival (OS) rates. Patients that received adjuvant chemotherapy showed equivalent effects on RFS (hazard ratio [HR] = 2.13; 95% confidence interval [CI] = 0.82–5.53) and worse on OS ([HR = 5.20; 95 %CI = 1.26–21.50) than patients who did not. This study did not show that adjuvant chemotherapy for FIGO Stages I–II endometrial cancer with recurrence risk factors has survival benefit. Further large-scale studies are necessary to validate our findings.