TURKISH JOURNAL OF ONCOLOGY 2000 , Vol 15 , Num 2
POSTOPERATIVE RADIOTHERAPY IN ENDOMETRIAL CARCINOMA: PROGNOSTIC FACTORS
DENİZ YALMAN, ZEYNEP ÖZSARAN, YAVUZ ANACAK, ÖMÜR KARAKOYUN ÇELİK, SERDAR ÖZKÖK, AYDIN ÖZSARAN, MERİH HANHAN, AYFER HAYDAROĞLU
Ege Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi AD., İzmir The records of 440 patients with endometrial carcinoma treated by postoperative radiotherapy between January 1985 - June 1997 were reviewed retrospectively in order to determine the prognostic factors influencing overall, disease-free and local recurrence-free survival. Median age of the patients was 57 (range: 35-83). Histologically 80.2% were adenocarcinoma, 5.7% adenosquamous carcinoma, 5.2% clear-cell carcinoma and 4.3% serous papillary carcinoma. The distribution by stages for Stage I, II, III and IV were 62.2%, 20.0%, 14.9% and 2.8% respectively. All patients received postoperative external radiotherapy with 1.8-2.0 Gy daily fractions up to 36-68 Gy (median 54 Gy). Intracavitary brachytherapy was applied to 61.8% of the cases. Survival analysis were performed using the Kaplan-Meier method. Log-rank test was used for univariate analysis and Cox regression model for multivariate analysis. Median follow-up time was 53 months (7-173 months). Total failure rate was 15.2% with 2.7% of patients having only a local failure, 2.0% local and distant failure and 10.5% distant failure only. Five-year overall, disease-free and local recurrence-free survival rates were 81.6%, 80.7% and 94.6% respectively. According to univariate analysis prognostic factors influencing disease-free survival were histologic type (P=0.0067), histologic grade (P=0.0015), stage (P<0.0001), myometrial invasion (P<0.0001), peritoneal cytology (P=0.0013) and cervical involvement (P=0.0106) while the prognostic factors affecting local recurrence-free survival were stage (P=0.0277), myometrial invasion (P=0.0054), peritoneal cytology (P=0.0427). According to multivariate analysis prognostic factors influencing disease-free survival were histologic type (P=0.0194), myometrial invasion (P=0.0021) and histologic grade (P=0.0303) while the only prognostic factor influencing local recurrence-free survival was myometrial invasion (P=0.0241). Keywords :