Does postoperative irradiation improve survival in early-stage endometrial cancer?

Brachytherapy. 2018 Nov-Dec;17(6):912-921. doi: 10.1016/j.brachy.2018.08.002. Epub 2018 Sep 3.

Abstract

Endometrial cancer is the most common gynecological cancer in developed countries. Postoperative irradiation has been shown to lower locoregional relapses among high-intermediate risk endometrial cancer patients. In addition, vaginal cuff brachytherapy has demonstrated similar control to external beam radiotherapy but with lower toxicity. Although randomized trials have failed to translate that into better overall survival, reports from large databases, such as the National Cancer Database and the Surveillance, Epidemiology, and End Results database, have shown evidence of a statistical relationship between postoperative irradiation and survival in the intermediate- and high-risk groups. This review will address the risk groups that have led the therapeutic decisions and then we will review the clinical results accordingly. Special attention will be paid to the survival results based on the data presented through an analysis of the large databases that suggest a possible survival benefit.

Keywords: Endometrial cancer; External beam radiotherapy; Postoperative radiotherapy; Survival; Vaginal cuff brachytherapy.

Publication types

  • Review

MeSH terms

  • Brachytherapy / methods*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / radiotherapy*
  • Endometrial Neoplasms / surgery
  • Female
  • Humans
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Radiotherapy, Adjuvant / methods
  • Risk Factors
  • Survival Rate
  • Treatment Outcome