Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3921334 | European Journal of Obstetrics & Gynecology and Reproductive Biology | 2008 | 6 Pages |
ObjectivePrimary uterine papillary serous (PS) and clear cell (CC) carcinoma are aggressive histologies characterized by elevated risk of loco-regional recurrence and disease-specific mortality following hysterectomy. The impact of adjuvant radiotherapy remains to be elucidated. The present study is a single institution, retrospective cohort comparison to determine whether post-hysterectomy radiotherapy improves loco-regional control and/or disease-specific survival outcomes in a population of women with PS and/or CC.Study designBetween June 1992 and November 2006, 50 women underwent hysterectomy alone (H) or hysterectomy with adjuvant radiotherapy (H + RT) for primary uterine PS and/or CC. RT involved either high dose-rate (HDR) brachytherapy, external beam RT, or both.ResultsAt a median survivor follow-up of 27 months (range 2.7–137.3) for the H + RT group and 61 months (range 11.9–114.6) for the H group (range 3–137), patients in the H + RT group demonstrated a trend toward superior disease-free survival (not yet attained at 26 months versus 25 months; p = 0.0625). For patients with ≥24 months of follow-up, disease recurrence was significantly higher in H patients over H + RT patients (45% versus 12.5%; p < 0.05). Additionally, the H + RT group demonstrated significant improvement in loco-regional control (0% versus 37.5%; p < 0.001), most pronounced within FIGO stages I–II H + RT patients (0% versus 70%; p < 0.001). Overall survival was not significantly different between the two cohorts (H = 32 months, H + RT = not yet attained at 26 months; p = non-significant).ConclusionsHysterectomy with adjuvant radiotherapy significantly improves disease-free survival within 2 years post-hysterectomy and significantly reduces loco-regional failures over hysterectomy alone.