Objective

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.

Study design

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).

Results

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.

Conclusion

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.

中文翻译：

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辅助化疗对早期子宫内膜癌生存的影响

客观的

国际妇产科联合会（FIGO）对于有复发危险因素的I-II期子宫内膜癌的辅助化疗尚无共识。这项研究评估了辅助化疗在改善这些患者生存方面的功效。

学习规划

我们对具有复发危险因素的FIGO I-II期子宫内膜癌患者进行了回顾性图表审查。这些患者在国立癌症中心医院（NCCH）没有接受辅助治疗，但在滋贺医科大学（SUMS）接受了铂类化疗。

结果

六百三十八名子宫内膜癌患者被确定。其中，118 人符合纳入标准，321 人被排除在 NCCH 之外，49 人符合纳入标准，150 人被排除在 SUMS 之外。对年龄、手术、主动脉旁淋巴结切除术、大网膜切除术、组织学类型、子宫肌层浸润、宫颈间质浸润和辅助治疗的多变量分析显示，在患者中年龄 > 60 岁的 II 型组织学、外半肌层浸润、宫颈间质浸润和腹膜细胞学阳性患者的无复发生存率 (RFS) 显着较差，而年龄 > 60 岁的 II 型组织学、外半子宫肌层浸润、宫颈间质浸润和腹膜细胞学阳性的患者的无复发生存率 (RFS) 显着较差。子宫肌层浸润和腹膜细胞学阳性的总生存率 (OS) 明显较差。与接受辅助化疗的患者相比，接受辅助化疗的患者对 RFS 的影响相当（风险比 [HR] = 2.13；95% 置信区间 [CI] = 0.82–5.53），但对 OS 的影响较差（[HR = 5.20；95% CI = 1.26–21.50）。没有的患者。

结论

这项研究并未表明辅助化疗对于具有复发危险因素的FIGO I-II期子宫内膜癌具有生存获益。需要进一步的大规模研究来验证我们的发现。