Survival in patients with paraaortic lymph node metastases from endometrial adenocarcinoma clinically limited to the uterus
| Autor: | M. L. Hicks, Trudy R. Baker, Ronald E. Hempling, Jeffrey L Puretz, Debra Walsh, Michael Mcauley, M.Steven Piver |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Uterus Adenocarcinoma Metastasis Radiotherapy High-Energy Paraaortic lymph nodes Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Lymph node Aged Aged 80 and over Radiation business.industry Endometrial cancer Middle Aged medicine.disease Combined Modality Therapy Endometrial Neoplasms Radiation therapy medicine.anatomical_structure Lymphatic Metastasis Uterine Neoplasms Female Lymph Radiology Progestins business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 26:607-611 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/0360-3016(93)90276-2 |
| Popis: | Purpose : The purpose of this study was (a) to evaluate the incidence of paraaortic lymph node metastasis from adenocarcinoma of the endometrium clinically limited to the uterus (1971 FIGO Stages I and II) and (b) to report the 5 year disease-free survival of patients with histologically documented paraaortic lymph node metastasis from endometrial adenocarcinoma clinically limited to the uterus treated on two separate protocols. Methods and Materials : From June 1979 to June 1990, 109 patients underwent staging paraaortic lymphadenectomy or paraaortic lymph node biopsy at the time of total abdominal hysterectomy and bilateral salpingo-oophorectomy for adenocarcinoma of the endometrium clinically limited to the uterus. Patients with histologically documented paraaortic lymph node metastasis were treated on two protocols: (a) pelvic radiation (5,040 cGy) plus progestins or (b) pelvic radiation therapy (5,040 cGy) plus paraaortic radiation (4,500 cGy). Results : Paraaortic lymph node metastases was primarily associated with grade 3 tumors (34.4%) and deep myometrial invasion (42%) and was present in 17.4% (19) of 109 patients. None of the women treated with pelvic radiation therapy and progestins survived five years disease-free. In contrast, the 5 year disease-free survival was 27% for patients treated by pelvic and paraaortic radiation. Conclusions : Since all patients with macroscopic metastases to the paranortic lymph nodes developed recurrent cancer and only a small percentage of those with microscopic metastases to the parasortic lymph nodes survived disease-free at 5 years, improved survival for patients with paaaortic lymph node metastases will necessitate the addition of effective cytotoxic chemotherapy to pelvic and parnaortic radiation. |
| Databáze: | OpenAIRE |
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