Abstract 3645
Background
Controversies exist for utility of adjuvant chemotherapy (AC) in early stage high risk endometrial cancer (EC). Our study sought to evaluate overall, relapse-free and cancer-specific survivals (OS, RFS, CSS) in patients with high risk FIGO stage I EC.
Methods
Per provincial guideline, high risk stage I EC eligible for AC was defined as 1) endometrioid histology, stage IB and grade 3 or 2) non-endometrioid histology with any myometrial invasion. We identified all consecutive patients with stage I EC from 6 cancer centres in British Columbia, Canada diagnosed between 2000 and 2010. CSS was defined as time between diagnosis and death due to endometrial cancer. Descriptive statistics were used to evaluate patient, disease and treatment characteristics; Cox proportional hazard regression was used to evaluate differences in OS, RFS and CSS.
Results
Among stage I EC (n = 1426), 24 with endometrioid histology and 214 with non-endometrioid histology with high risk characteristics were identified (n = 238). Median age was 66 (range 33-91); stage IA = 196, IB = 50; grade 1=16, 2=20, 3=196; LVI+ 88. Among all high risk patients, OS (RR 0.37, 95% CI 0.20-0.71, p = 0.002; median 6.3 vs 12.2 years) and RFS (RR 0.35, 95% CI 0.19-0.65, p = 0.001; median 5.6 vs 12.2 years) were significantly better in patients who received AC, but CSS (RR 0.65, 95% CI 0.32-1.33, p = 0.24; median not reached in both groups) was not statistically improved although numerically favoured AC. Similarly, among non-endometrioid histology, OS (RR 0.40, 95% CI 0.20-0.78, p = 0.008; median 6.4 vs 12.2 years) and RFS (RR 0.38, 95% CI 0.20-0.72, p = 0.03; median 5.9 vs 12.2 years) were significantly better in patients who received AC, but improvements in CSS with AC (RR 0.68, 95% CI 0.3-1.4, p = 0.32; median not reached in both groups) were not statistically significant.
Conclusions
Despite its use, there is insufficient evidence that AC reduces risk of death due to cancer in high risk stage I EC, although DSS is numerically improved in patients who received AC. Improvements in OS and RFS associated with chemotherapy may be largely attributed to other confounding factors. Future prospective studies are needed to clarify the role of contemporary AC in high risk stage I EC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2376 - Patient Reported Outcomes (PRO) in patients (pts) with HER2- advanced breast cancer (ABC) and a germline BRCA1/2 mutation (gBRCAm) receiving talazoparib (TALA) vs physician’s choice chemotherapy (PCT) in the EMBRACA trial: A focus on subgroups with/ without visceral disease
Presenter: Johannes Ettl
Session: Poster Display session 2
Resources:
Abstract
4874 - Complete Responses in Patients With 2nd-Line or Greater Metastatic Triple-Negative Breast Cancer (TNBC) Following First-in-Human Immunotherapy Combining NK and T Cell Activation with Off-the-Shelf High-Affinity CD16 NK Cell Line (haNK)
Presenter: Chaitali Nangia
Session: Poster Display session 2
Resources:
Abstract
4362 - Reproducibility and concordance of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays in triple-negative breast cancer (TNBC)
Presenter: Aurelia Noske
Session: Poster Display session 2
Resources:
Abstract
4528 - Systemic Therapy in 2nd-Line Metastatic Triple Negative Breast Cancer (mTNBC): A Systematic Literature Review (SLR) and Meta-Analysis (MA) of Efficacy
Presenter: Peter Kaufman
Session: Poster Display session 2
Resources:
Abstract
4112 - Cisplatin given at three divided doses for three consecutive days in metastatic breast cancer: an alternative schedule for one full dose with comparable efficacy but less CINV and hypomagnesaemia
Presenter: Yang Chen
Session: Poster Display session 2
Resources:
Abstract
5699 - Patterns and predictors of first-line (1L) taxane use in US patients with metastatic triple-negative breast cancer (mTNBC)
Presenter: Joyce O’Shaughnessy
Session: Poster Display session 2
Resources:
Abstract
1931 - Maintenance Chemotherapy is effective in Patients with Metastatic Triple Negative Breast Cancer After First-line Platinum-based Chemotherapy
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract
4696 - Using the Patient-Reported Outcomes Measurement Information System (PROMIS) to investigate symptom burden enrichment in Stage IV patients at an academic center
Presenter: Madeline Matthys
Session: Poster Display session 2
Resources:
Abstract
4582 - Measures of functional status in adults aged ≥70 years with advanced breast cancer (ABC) receiving palbociclib (PAL) combination therapy in POLARIS
Presenter: Meghan Karuturi
Session: Poster Display session 2
Resources:
Abstract
3565 - Real-World 1-Year Survival Analysis of Patients with Metastatic Breast Cancer with Liver or Lung Metastasis Treated with Eribulin, Gemcitabine or Capecitabine
Presenter: Shayma Kazmi
Session: Poster Display session 2
Resources:
Abstract