dc.contributor.author | Forsse, David Erik | |
dc.contributor.author | Berg, Hege Fredriksen | |
dc.contributor.author | Bozickovic, Olivera | |
dc.contributor.author | Engerud, Hilde Renate | |
dc.contributor.author | Halle, Mari Kyllesø | |
dc.contributor.author | Høivik, Erling Andre | |
dc.contributor.author | Woie, Kathrine | |
dc.contributor.author | Werner, Henrica Maria Johanna | |
dc.contributor.author | Haldorsen, Ingfrid S. | |
dc.contributor.author | Trovik, Jone | |
dc.contributor.author | Krakstad, Camilla | |
dc.date.accessioned | 2021-05-04T09:50:34Z | |
dc.date.available | 2021-05-04T09:50:34Z | |
dc.date.created | 2021-01-03T12:51:01Z | |
dc.date.issued | 2020 | |
dc.Published | Gynecologic Oncology. 2020, 1-9. | |
dc.identifier.issn | 0090-8258 | |
dc.identifier.uri | https://hdl.handle.net/11250/2753451 | |
dc.description.abstract | Objective: Main controversies in endometrial cancer treatment include the role of lymphadenectomy and optimal adjuvant treatment. We assessed clinical outcome in a population-based endometrial cancer cohort in relation to changes in treatment management over two decades.
Methods: All consenting endometrial cancer patients receiving primary treatment at Haukeland University Hospital from 2001 to 2019 were included (n = 1308). Clinicopathological variables were evaluated for year-to-year changes. Clinical outcome before and after discontinuing adjuvant radiotherapy and individualizing extent of lymphadenectomy was analyzed.
Results: The rate of lymphadenectomy was reduced from 78% in 2001–2012 to 53% in 2013–2019. The rate of patients with verified lymph node metastases was maintained (9% vs 8%, p = 0.58) and FIGO stage I patients who did not undergo lymphadenectomy had stable 3-year recurrence-free survival (88% vs 90%, p = 0.67). Adjuvant chemotherapy for completely resected FIGO stage III patients increased from 27% to 97% from 2001 to 2009 to 2010–2019, while adjuvant radiotherapy declined from 57% to 0% (p < 0.001). These patients had improved 5-year overall- and recurrence-free survival; 0.49 [95% CI: 0.37–0.65] in 2001–2009 compared to 0.61 [0.45–0.83] in 2010–2019, p = 0.04 and 0.51 [0.39–0.68] to 0.71 [0.60–0.85], p = 0.03, respectively. For stage I, II and IV, survival rates were unchanged.
Conclusions: Our study demonstrates that preoperative stratification by imaging and histological assessments permits a reduction in lymphadenectomy to around 50%, and is achievable without an increase in recurrences at 3 years. In addition, our findings support that adjuvant chemotherapy alone performs equally to adjuvant radiotherapy with regard to survival, and is likely superior in advanced stage patients. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Elsevier | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Maintained survival outcome after reducing lymphadenectomy rates and optimizing adjuvant treatment in endometrial cancer | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2020 The Author(s). | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |
dc.identifier.doi | 10.1016/j.ygyno.2020.12.002 | |
dc.identifier.cristin | 1864387 | |
dc.source.journal | Gynecologic Oncology | en_US |
dc.source.pagenumber | 396-404 | en_US |
dc.identifier.citation | Gynecologic Oncology. 2021, 160 (2), 396-404 | en_US |
dc.source.volume | 160 | en_US |
dc.source.issue | 2 | en_US |