Disease-free survival after vaginal vault brachytherapy versus observation for patients with node-negative intermediate-risk endometrial adenocarcinoma

Obermair, Andreas, Cheuk, Robyn, Pak, Sok Cheon, Perrin, Lewis, Nicklin, James, Crandon, Alex, Land, Russell, Kondalsamy Chennakes, Srinivas, Janda, Monika and Tripcony, Lee (2008) Disease-free survival after vaginal vault brachytherapy versus observation for patients with node-negative intermediate-risk endometrial adenocarcinoma. Gynecologic Oncology, 110 3: 280-285. doi:10.1016/j.ygyno.2008.05.028


Author Obermair, Andreas
Cheuk, Robyn
Pak, Sok Cheon
Perrin, Lewis
Nicklin, James
Crandon, Alex
Land, Russell
Kondalsamy Chennakes, Srinivas
Janda, Monika
Tripcony, Lee
Title Disease-free survival after vaginal vault brachytherapy versus observation for patients with node-negative intermediate-risk endometrial adenocarcinoma
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 0090-8258
Publication date 2008-09
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2008.05.028
Volume 110
Issue 3
Start page 280
End page 285
Total pages 6
Editor Beth Y. Karlan
Place of publication New York
Publisher Academic Press
Collection year 2009
Language eng
Subject 1112 Oncology and Carcinogenesis
111208 Radiation Therapy
111402 Obstetrics and Gynaecology
C1
Formatted abstract
Purpose

To compare the disease-free survival (DFS) of patients with surgical stage 1, intermediate-risk endometrial adenocarcinoma (EAC) treated with primary surgery with or without adjuvant vaginal vault brachytherapy (VVBT).

Patients and methods


A retrospective chart review identified 575 patients with stage 1B, 1C or 2A endometrial cancer who had surgery between 1990 and 2004. All patients were surgically staged and 259 patients received postoperative VVBT. The date and site of first recurrence were considered the primary statistical endpoints and were analysed by univariate and multivariate Cox models. Subgroups of patients stratified by substage and grade were created and Log-rank tests using vaginal recurrence as the endpoint were calculated within these groups.

Results


After a mean follow-up period of 72 months (95%-confidence interval (CI): 68 to 75 months) a total of 43 (7.5%) patients developed recurrence. Multivariate analysis demonstrated that increasing patient's age at diagnosis and stage 1C or 2A disease were independent risk factors for recurrence whereas the grade of differentiation and the type of treatment (surgery alone vs. surgery followed by postoperative VVBT) were not associated with a change in DFS. Analysis within the subgroups stratified by substage and grade did not even reveal a trend towards improved local control with VVBT.

Conclusion


Postoperative VVBT was not associated with a measurable reduction in the risk of recurrence in surgical stage 1, intermediate-risk endometrial cancer.
Keyword Endometrial Cancer
Vaginal vault brachytherapy
recurrence
Q-Index Code C1
Q-Index Status Confirmed Code
Additional Notes Received 31 December 2007. Available online 29 August 2008.

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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