Radiation therapy as exclusive treatment for medically inoperable patients with stage I and II endometrioid carcinoma of the endometrium

David A. Fishman, Kenneth B. Roberts, Joseph T. Chambers, Ernest I. Kohorn, Peter E. Schwartz, Setsuko K Chambers

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Abstract

From 1975 to 1992, 54 patients with clinical Stage I and II endometrioid carcinoma of the endometrium, representing 3.5% of all such patients, were deemed medically inoperable and exclusively received radiation therapy. A cohort of 108 operable patients adjusted for age, clinical stage, and grade served as a control group. The 5-year actuarial cancer-specific survivals for patients with Stage I inoperable, Stage II inoperable, Stage I operable, and Stage II operable disease were 80, 85, 98, and 100%. The corresponding 5- year overall survival rates were 30, 24, 88, and 85%. Inoperable patients had a median disease-free interval of 36 months for clinical Stage I and 50 months for Stage II disease versus 74.5 and 77 months for the operable patients (P = 0.001). Inoperable patients with Stage I disease had a median survival of 37 months versus 50 months for Stage II (P = Ns), with only 7 (13%) of these patients dying with endometrial cancer. Operable patients had a median survival of 75 and 79 months in Stage I and II, respectively, with 14 patients dying with endometrial carcinoma (13%). Stage I and II inoperable patients had significantly shorter survival than operable patients (P < 0.0001). More deaths from intercurrent disease occurred within the inoperable Stage I group than with the operable group (28 of 32 vs 3 of 15, P < 0.0001). Inoperable patients had a significantly shorter overall survival and more deaths due to intercurrent disease than operable patients (P < 0.0001). However, inoperable patients who did not die from intercurrent disease had a median 5-year survival which approaches that of operable patients. Our study demonstrates that exclusive radiation therapy is a well-tolerated and effective treatment for medically inoperable patients.

Original languageEnglish (US)
Pages (from-to)189-196
Number of pages8
JournalGynecologic Oncology
Volume61
Issue number2
DOIs
StatePublished - May 1996
Externally publishedYes

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Endometrioid Carcinoma
Endometrial Neoplasms
Radiotherapy
Therapeutics
Survival

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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Radiation therapy as exclusive treatment for medically inoperable patients with stage I and II endometrioid carcinoma of the endometrium. / Fishman, David A.; Roberts, Kenneth B.; Chambers, Joseph T.; Kohorn, Ernest I.; Schwartz, Peter E.; Chambers, Setsuko K.

In: Gynecologic Oncology, Vol. 61, No. 2, 05.1996, p. 189-196.

Research output: Contribution to journalArticle

Fishman, David A. ; Roberts, Kenneth B. ; Chambers, Joseph T. ; Kohorn, Ernest I. ; Schwartz, Peter E. ; Chambers, Setsuko K. / Radiation therapy as exclusive treatment for medically inoperable patients with stage I and II endometrioid carcinoma of the endometrium. In: Gynecologic Oncology. 1996 ; Vol. 61, No. 2. pp. 189-196.
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abstract = "From 1975 to 1992, 54 patients with clinical Stage I and II endometrioid carcinoma of the endometrium, representing 3.5{\%} of all such patients, were deemed medically inoperable and exclusively received radiation therapy. A cohort of 108 operable patients adjusted for age, clinical stage, and grade served as a control group. The 5-year actuarial cancer-specific survivals for patients with Stage I inoperable, Stage II inoperable, Stage I operable, and Stage II operable disease were 80, 85, 98, and 100{\%}. The corresponding 5- year overall survival rates were 30, 24, 88, and 85{\%}. Inoperable patients had a median disease-free interval of 36 months for clinical Stage I and 50 months for Stage II disease versus 74.5 and 77 months for the operable patients (P = 0.001). Inoperable patients with Stage I disease had a median survival of 37 months versus 50 months for Stage II (P = Ns), with only 7 (13{\%}) of these patients dying with endometrial cancer. Operable patients had a median survival of 75 and 79 months in Stage I and II, respectively, with 14 patients dying with endometrial carcinoma (13{\%}). Stage I and II inoperable patients had significantly shorter survival than operable patients (P < 0.0001). More deaths from intercurrent disease occurred within the inoperable Stage I group than with the operable group (28 of 32 vs 3 of 15, P < 0.0001). Inoperable patients had a significantly shorter overall survival and more deaths due to intercurrent disease than operable patients (P < 0.0001). However, inoperable patients who did not die from intercurrent disease had a median 5-year survival which approaches that of operable patients. Our study demonstrates that exclusive radiation therapy is a well-tolerated and effective treatment for medically inoperable patients.",
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