PV QA 4 - Poster Viewing Q&A 4
TU_20_3521 - Clinical Outcomes Following Adjuvant Management of FIGO Stage II Endometrial Cancer
Location: Innovation Hub, Exhibit Hall 3
Poster Presenter(s)
Homan Mohammadi, MD
Clinical Outcomes Following Adjuvant Management of FIGO Stage II Endometrial Cancer
H. Mohammadi1, Y. A. Abuodeh2, A. O. Naghavi1, D. C. Fernandez1, M. E. Montejo1, S. M. Apte1, M. S. Hoffman1, M. M. Shahzad3, R. M. Wenham1, H. S. Chon3, and K. A. Ahmed1; 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 2H. Lee Moffitt Cancer Center and Research Institute, Department of Radiation Oncology, Tampa, FL, 3Moffitt Cancer Center, Tampa, FL
Purpose/Objective(s): Multiple adjuvant treatment options are available for patients with FIGO stage II endometrial cancer. Treatment options may include vaginal brachytherapy (VBT), external beam radiation (EBRT), and/or chemotherapy. The purpose of this abstract was to assess failure patterns following various combinations of adjuvant treatment.
Materials/Methods: A total of 71 patients were identified with FIGO stage II endometrial cancer following transabdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). Pelvic lymph node dissection was carried out in all patients with a paraaortic lymph node dissection in n = 33 (46%). Sarcoma histologies were excluded from this study. Patients were treated between March 2008 to January 2017 and followed until January 2018. Details including clinical characteristics, treatments, and outcomes were extracted from retrospective chart review and radiologic examinations.
Results: Our patient cohort most commonly had grade 3 tumors (n = 33, 46%), followed by grade 2 (n = 23, 32%), and grade 1 (n = 15; 21%). Greater than 50% myometrial invasion was noted in the majority (n = 40, 56%) with LVSI noted in n = 24 (34%). Median age of patients at the time of surgical resection was 64 years old (range: 34 - 93). Grade 1 - 2 tumors were treated with no radiation, VBT, EBRT, or both VBT and EBRT in 18%, 31%, 11%, and 39% of cases, respectively. Chemotherapy was received by 18% of patients with grade 1 - 2 tumors. Grade 3 tumors were treated with no radiation, VBT, or both VBT and EBRT in 33%, 27%, and 39% of cases, respectively. Chemotherapy was received by the majority of patients with grade 3 tumors (67%). Median follow-up was 24.5 months. Two pelvic recurrences were noted in grade 3 tumors with an overall 36-month pelvic control rate of 97%. The most common site of failure was distant with 12-, 24-, and 36-month distant control rates of 98%, 86%, and 80%, respectively. Grade 3 tumors were more likely to have distant recurrence than grades 1-2 tumors (HR 6.9, 95% CI 1.6 – 47.1; p = 0.007) and receipt of chemotherapy improved distant control in grade 3 tumors (HR 0.15, 95% CI 0.02 - 0.93; p = 0.04). The 12-, 24-, and 36-month local (vaginal) control rates were 98%, 98%, and 92%, respectively. Receipt of either VBT or EBRT reduced the risk of local recurrence with 24-month local control rates of 100% vs. 93% (p = 0.04), respectively.
Conclusion: In our cohort of FIGO stage II patients following TAH-BSO with lymph node dissection, local control was improved by the receipt of either VBT of EBRT. The most common site of failure was distant. Novel strategies are needed to improve distant control in grade 3 tumors.
Author Disclosure: H. Mohammadi: None. D.C. Fernandez: None. S.M. Apte: None. R.M. Wenham: None. K.A. Ahmed: None.
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Title: Clinical Outcomes Following Adjuvant Management of FIGO Stage II Endometrial Cancer
Time: 2:45 PM - 4:15 PM