Impacts of Postoperative Adjuvant Therapies on the Survival of Women with High-Risk Early-Stage Endometrial Cancer: A Cohort Study

초록

Background/Objectives: The survival outcomes according to postoperative adjuvant therapeutic strategy in women with high-risk early-stage endometrial cancer (EEC) have not been clearly compared. This study examined the impacts of various postoperative adjuvant therapies on the survival of women with high-risk EEC. Methods: Korean Health Insurance Review and Assessment Service data related to Korean cancer registration data were used. The data of 1341 women who met the eligibility criteria for high-risk EEC were selected. The overall survival (OS) after the women had received various postoperative adjuvant therapies was analyzed. Results: The mean age of the women was 58.2 +/- 10.3 years, and they were followed up for 5.9 +/- 4.0 years. When compared with primary surgery alone, the OS was similar in the women who had received adjuvant external beam radiation therapy (EBRT) +/- vaginal brachytherapy (VB), adjuvant VB alone, adjuvant chemotherapy, or adjuvant hormone therapy in combination with primary surgery, but the OS was significantly lower in the women who had received adjuvant chemoradiotherapy combined with primary surgery (HR 3.083; 95% CI 1.311-7.247; p = 0.010). In addition, compared to adjuvant EBRT +/- VB, the OS was significantly lower in the group given adjuvant radiotherapy after chemotherapy (HR 11.87; 95% CI 4.595-30.664; p < 0.001), but the OS was similar in the women who had received adjuvant VB alone, adjuvant concurrent chemoradiotherapy, or adjuvant chemotherapy after radiotherapy. Conclusions: Except for adjuvant radiotherapy after chemotherapy, postoperative adjuvant therapies have similar impacts on the survival of women with high-risk EEC.

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