Gynecology & Obstetrics
Open Access

Abstract

Aspirin and Warfarin are Associated with Improved Overall Survival in Medically Inoperable Endometrial Cancer Patients Treated with Radiation Therapy

Hubert Fornalik, Michael J. Goodheart, Thomas E. Buekers, Koen De Geest and Geraldine M Jacobson

Objective:To assess factors associated with improved survival of medically inoperable endometrial carcinoma.

Methods:Patients with endometrial cancer who were not surgical candidates, underwent primary radiation therapy. Data were collected from medical records Survival estimates were calculated and compared.

Results:Twenty-nine of 39 patients who underwent primary radiation therapy were considered medically inoperable. Median follow up was 19 months (range 3-66). Overall survival (OS) was 38% (11 out of 29). Progression-free survival (PFS) was 34% (10 out of 29). The cancer-specific mortality was 14% (4 out 29). Fourteen of 18 deceased patients (78%) had no evidence of recurrent disease. A history of pulmonary embolism was associated with improved survival (Rate ratio of death 0.2; 95%CI, 0.01-0.98; p=0.046). Grade 3 tumors were associated with shorter survival, compared to combined grades 1 and 2 (Rate ratio of death 3.21; 95%CI, 1-8.76; p=0.05). The median OS in patients on aspirin or warfarin was 20 months (range 7-66), and 11 months (range 3-43) in patients who did not take aspirin or warfarin (Rate ratio of death: 0.35, 95%CI, 0.13-0.89; p=0.028).

Conclusion: Radiation therapy provides acceptable tumor control in patients with medically inoperable endometrial cancer. Aspirin or warfarin therapy may result in longer overall survival.