Patients with FIGO stage 3 endometrial cancer often receive adjuvant therapy, but level I evidence is lacking. The purpose of this study was to evaluate relapse-free survival (RFS), disease-free survival (DFS) and overall survival (OS) in patients with FIGO stage 3A to 3C2 patients by treatment modality received and risk factors.
Consecutive patients with FIGO stage 3 endometrial cancer treated from 2000-2010 were identified in the provincial cancer registry. Clinicopathologic characteristics, adjuvant treatments and outcomes were compared using descriptive and multivariable analyses.
261 patients had stage 3 endometrial cancer, 132 with stage 3A, 9 with 3B, 85 with 3C1 and 35 with 3C2. 39 had FIGO grade 1 disease; 73, grade 2; 147, grade 3. 160 had endometrioid and 35 had serous carcinoma. 170 (65%) had >50% myometrial invasion;162 (62%) had presence of LVI. 161 patients received both adjuvant chemotherapy (CT) and radiotherapy (RT); 33 received RT only; 32 received CT only; 35 received neither. 5-year (5Y) RFS, DFS and OS were similar among stage IIIA (RFS 55.1%, DFS 46.7%, OS 58.5%), IIIB (RFS 50.8%, DFS 50.8%, OS 58.5%), IIIC1 (RFS 45.4%, DFS 44%, OS 49.9%) and IIIC2 (RFS 42%, DFS 42%, OS 41.6%). Use of adjuvant RT was associated with improved median RFS (57.2 vs. 16.9m, p
In FIGO stage III endometrial cancer patients, use of both CT and RT is associated with improved RFS, DFS and OS and therefore should be recommended in all eligible patients after resection. 5Y RFS, DFS and OS are similar across stages IIIA to IIIC2. Risk factors including age, high grade and deep myometrial invasion are independent predictors of survival.
Clinical trial identification
Legal entity responsible for the study
BC Cancer Agency
J.J. Ko: Received honorarium from Janssen, Astellas, Bristol-Myers Squib and Merck. Participated in the advisory board for Bristol-Myers Squib, Merck and AstraZeneca. A. Kumar: Participated in advisory boards for Celgene, Roche-Peru, and AMtene. All other authors have declared no conflicts of interest.