Impact of External Radiotherapy on Survival after Stage I Endometrial Cancer: Results from a Population-Based StudyPierre-Marie Tebeu1,4,5*, Helena M Verkooijen2, Youri Popowski3, Christine Bouchardy2, Frank Ludicke4, Massimo Usel2 and Attila L Major1,4
- *Corresponding Author:
- Dr. Pierre Marie Tebeu, MD, MPH
Department of Obstetrics and Gynaecology
University Teaching Hospital, Switzerland
Tel: 00 237 77 67 55 33
E-mail: [email protected]
Received date: October 03, 2010; Accepted date: December 2, 2010; Published date: December 15, 2010
Citation: Tebeu PM, Verkooijen HM, Popowski Y, Bouchardy C, Ludicke F, et al. (2011) Impact of External Radiotherapy on Survival after Stage I Endometrial Cancer: Results from a Population-Based Study. J Cancer Sci Ther 3: 041-046. doi: 10.4172/1948-5956.1000055
Copyright: © 2011 Tebeu PM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Purpose: To assess the impact of external radiotherapy on the survival of patients with early stage endometrial cancer in a population-based setting. Patients and methods: Using information from the Geneva Cancer Registry, we identified all patients who underwent operations for endometrial cancer between 1980 and 1996. We excluded patients with tumours that had spread beyond the uterus, patients without myometrial invasion and patients with poorly differentiated, deeply invasive tumours. Adjusting for other prognostic variables, a Cox proportional hazards analysis was used to calculate the diseasespecific risks and the overall mortality risks in patients treated with brachytherapy or external radiotherapy compared with non-irradiated patients. Stratified analyses were performed for patients with 'low-risk' (superficial myometrial invasion, grades 1-2) and 'high-risk' (superficial invasion grade 3 or deep invasion grades 1-2) tumours. Results: For the 162 patients with low-risk tumours, external radiotherapy was significantly associated with an increased overall mortality (hazard ratio [HR]: 6.4, 95% CI: 1.3-30.2) and endometrial cancer mortality (HR: 9.4, 95% CI: 1.0-86.7). In the group of patients with high-risk tumours (n=108), neither brachytherapy nor external radiotherapy modified the endometrial cancer mortality risk. Conclusion: External radiotherapy does not reduce mortality from early stage endometrial cancer and is associated with a significantly increased overall and endometrial cancer mortality risk among patients with superficially invasive grade 1-2 tumours.