Journal article
Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?
Practical Radiation Oncology, v 12(2), pp e123-e134
Mar 2022
PMID: 34822999
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate the impact of prophylactic paraortic lymph node (PALN) radiation therapy (RT) on clinical outcomes in patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 endometrial cancer (EC).
A multi-institutional retrospective study included patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 EC lymph node assessment, status postsurgical staging, followed by adjuvant chemotherapy and RT using various sequencing regimens. Overall survival (OS) and recurrence-free survival (RFS) rates were estimated by the Kaplan-Meier method. Univariable and multivariable analysis were performed by Cox proportional hazard models for RFS/OS. In addition, propensity score matching was used to estimate the effect of the radiation field extent on survival outcomes.
A total of 378 patients were included, with a median follow-up of 45.8 months. Pelvic RT was delivered to 286 patients, and 92 patients received pelvic and PALN RT. The estimated OS and RFS rates at 5 years for the entire cohort were 80% and 69%, respectively. There was no difference in the 5-year OS (77% vs 87%, P = .47) and RFS rates (67% vs 70%, P = .78) between patients treated with pelvic RT and those treated with pelvic and prophylactic PALN RT, respectively. After propensity score matching, the estimated hazard ratios (HRs) of prophylactic PALN RT versus pelvic RT were 1.50 (95% confidence interval, 0.71-3.19; P = .28) for OS and 1.24 (95% confidence interval, 0.64-2.42; P = .51) for RFS, suggesting that prophylactic PALN RT does not improve survival outcomes. Distant recurrence was the most common site of first recurrence, and the extent of RT field was not associated with the site of first recurrence (P = .79).
Prophylactic PALN RT was not significantly associated with improved survival outcomes in stage IIIC1 EC. Distant metastasis remains the most common site of failure despite routine use of systemic chemotherapy. New therapeutic approaches are necessary to optimize the outcomes for women with stage IIIC1 EC.
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Details
- Title
- Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma?
- Creators
- Jennifer Yoon - Rutgers, The State University of New JerseyHalle Fitzgerald - Rutgers, The State University of New JerseyYaqun Wang - Rutgers, The State University of New JerseyQingyang Wang - Rutgers, The State University of New JerseyIrina Vergalasova - Rutgers, The State University of New JerseyMohamed A. Elshaikh - The Barbara Ann Karmanos Cancer InstituteIrina Dimitrova - Departments of Gynecologic Oncology, Henry Ford Cancer Institute, Detroit, MichiganShari Damast - Yale UniversityJessie Y. Li - Yale UniversityEmma C. Fields - Virginia Commonwealth UniversitySushil Beriwal - UPMC Hillman Cancer CenterAndrew Keller - UPMC Hillman Cancer CenterElizabeth A. Kidd - Stanford UniversityMelissa Usoz - Stanford UniversityShruti Jolly - University of Michigan–Ann ArborElizabeth Jaworski - University of Michigan–Ann ArborEric W. Leung - Sunnybrook Health Science CentreElysia Donovan - Sunnybrook Health Science CentreNeil K. Taunk - University of PennsylvaniaJunzo Chino - Duke Medical CenterDivya Natesan - Duke Medical CenterAndrea L. Russo - Massachusetts General HospitalJayanthi S. Lea - The University of Texas Southwestern Medical CenterKevin V. Albuquerque - The University of Texas Southwestern Medical CenterLarissa J. Lee - Dana-Farber Brigham Cancer CenterLara Hathout - Rutgers, The State University of New Jersey
- Publication Details
- Practical Radiation Oncology, v 12(2), pp e123-e134
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000766662900018
- Scopus ID
- 2-s2.0-85122951148
- Other Identifier
- 991021897383504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging