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dc.contributor.authorForsse, David Erik
dc.contributor.authorBerg, Hege Fredriksen
dc.contributor.authorBozickovic, Olivera
dc.contributor.authorEngerud, Hilde Renate
dc.contributor.authorHalle, Mari Kyllesø
dc.contributor.authorHøivik, Erling Andre
dc.contributor.authorWoie, Kathrine
dc.contributor.authorWerner, Henrica Maria Johanna
dc.contributor.authorHaldorsen, Ingfrid S.
dc.contributor.authorTrovik, Jone
dc.contributor.authorKrakstad, Camilla
dc.date.accessioned2021-05-04T09:50:34Z
dc.date.available2021-05-04T09:50:34Z
dc.date.created2021-01-03T12:51:01Z
dc.date.issued2020
dc.PublishedGynecologic Oncology. 2020, 1-9.
dc.identifier.issn0090-8258
dc.identifier.urihttps://hdl.handle.net/11250/2753451
dc.description.abstractObjective: 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.isoengen_US
dc.publisherElsevieren_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleMaintained survival outcome after reducing lymphadenectomy rates and optimizing adjuvant treatment in endometrial canceren_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2020 The Author(s).en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2
dc.identifier.doi10.1016/j.ygyno.2020.12.002
dc.identifier.cristin1864387
dc.source.journalGynecologic Oncologyen_US
dc.source.pagenumber396-404en_US
dc.identifier.citationGynecologic Oncology. 2021, 160 (2), 396-404en_US
dc.source.volume160en_US
dc.source.issue2en_US


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