Preoperative radiotherapy and surgery for endometrial carcinoma: prognostic significance of the sterilization of the specimen
Identifieur interne : 000831 ( France/Analysis ); précédent : 000830; suivant : 000832Preoperative radiotherapy and surgery for endometrial carcinoma: prognostic significance of the sterilization of the specimen
Auteurs : Philippe Maingon [France] ; Laurent Arnould [France] ; Valérie Magnin [France] ; Françoise Collin [France] ; Catherine Belichard [France] ; Jean Fraisse [France] ; Isabelle Barillot [France] ; Anne D Ombres [France] ; Marie-Christine Bône-Lepinoy [France] ; Marie-Martine Padeano [France] ; Serge Douvier [France] ; Jean Cuisenier [France] ; Jean-Claude Horiot [France]Source :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 1998.
Descripteurs français
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
Introduction: We report a retrospective study on the analysis of the operative specimen after preoperative radiotherapy for FIGO (1971) stage I or II endometrial carcinoma. Methods and Materials: From 1976 to 1996, 221 patients were treated with external radiotherapy (XRT) and/or low-dose-rate brachytherapy (BT) followed by surgery (S). Patients with cervical involvement (89 patients) or with high-grade tumors (49 patients) received XRT and BT. Patients stage FIGO Ia (89 patients) or with low-grade tumors (57 patients) received BT alone. Surgery was performed 5 to 6 weeks after irradiation. Results: The mean follow-up is 78 months (12–216). The 5-year survival was 90% for FIGO Ia, 80% for FIGO Ib, and 84% for FIGO II (p = 0.51). According to the differentiation, 5-year survival was 87% for grade 1, 84% for grade 2, 84% for grade 3 (p = 0.10). Grade 3 complications were registered in 2% (no grade 4). The tumors were sterilized in 37 patients (17%), sterilized but with dystrophic glands in 34 patients (16%), only modified and altered in 21 patients (9.5%), with viable cells in 56 patients (26%). After preoperative radiotherapy, 37/148 specimens were sterilized (25%), 14/74 after brachytherapy and surgery (19%), 23/74 after external radiotherapy–brachytherapy and surgery (31%). According to the response of the specimen, 5-year survival was 87% when the tumor was sterilized, 96% when altered glands were present, 85% when modified, and 76% if residual tumor with viable cells was identified (p = 0.043). Conclusion: Preoperative radiotherapy followed by surgery is a safe and effective treatment of FIGO stage I or II endometrial carcinomas. BT with two uterine tubes seems to be of interest in the contribution of the treatment of the uterus to sterilize the specimen. The analysis of this new prognostic factor remains important to select a population with worst prognosis.
Url:
DOI: 10.1016/S0360-3016(98)00074-1
Affiliations:
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wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Centre Georges-François Leclerc, 1 rue du Pr Marion, 21034 Dijon Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Horiot, Jean Claude" sort="Horiot, Jean Claude" uniqKey="Horiot J" first="Jean-Claude" last="Horiot">Jean-Claude Horiot</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Centre Georges-François Leclerc, 1 rue du Pr Marion, 21034 Dijon Cedex</wicri:regionArea><wicri:noRegion>21034 Dijon Cedex</wicri:noRegion><wicri:noRegion>21034 Dijon Cedex</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1998">1998</date><biblScope unit="volume">41</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="551">551</biblScope><biblScope unit="page" to="557">557</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brachytherapy</term><term>Endometrial carcinoma</term><term>Radiotherapy</term><term>Surgery</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Introduction: We report a retrospective study on the analysis of the operative specimen after preoperative radiotherapy for FIGO (1971) stage I or II endometrial carcinoma. Methods and Materials: From 1976 to 1996, 221 patients were treated with external radiotherapy (XRT) and/or low-dose-rate brachytherapy (BT) followed by surgery (S). Patients with cervical involvement (89 patients) or with high-grade tumors (49 patients) received XRT and BT. Patients stage FIGO Ia (89 patients) or with low-grade tumors (57 patients) received BT alone. Surgery was performed 5 to 6 weeks after irradiation. Results: The mean follow-up is 78 months (12–216). The 5-year survival was 90% for FIGO Ia, 80% for FIGO Ib, and 84% for FIGO II (p = 0.51). According to the differentiation, 5-year survival was 87% for grade 1, 84% for grade 2, 84% for grade 3 (p = 0.10). Grade 3 complications were registered in 2% (no grade 4). The tumors were sterilized in 37 patients (17%), sterilized but with dystrophic glands in 34 patients (16%), only modified and altered in 21 patients (9.5%), with viable cells in 56 patients (26%). After preoperative radiotherapy, 37/148 specimens were sterilized (25%), 14/74 after brachytherapy and surgery (19%), 23/74 after external radiotherapy–brachytherapy and surgery (31%). According to the response of the specimen, 5-year survival was 87% when the tumor was sterilized, 96% when altered glands were present, 85% when modified, and 76% if residual tumor with viable cells was identified (p = 0.043). Conclusion: Preoperative radiotherapy followed by surgery is a safe and effective treatment of FIGO stage I or II endometrial carcinomas. BT with two uterine tubes seems to be of interest in the contribution of the treatment of the uterus to sterilize the specimen. The analysis of this new prognostic factor remains important to select a population with worst prognosis.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Bourgogne</li><li>Bourgogne-Franche-Comté</li></region><settlement><li>Dijon</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name></noRegion><name sortKey="Arnould, Laurent" sort="Arnould, Laurent" uniqKey="Arnould L" first="Laurent" last="Arnould">Laurent Arnould</name><name sortKey="Barillot, Isabelle" sort="Barillot, Isabelle" uniqKey="Barillot I" first="Isabelle" last="Barillot">Isabelle Barillot</name><name sortKey="Belichard, Catherine" sort="Belichard, Catherine" uniqKey="Belichard C" first="Catherine" last="Belichard">Catherine Belichard</name><name sortKey="Bone Lepinoy, Marie Christine" sort="Bone Lepinoy, Marie Christine" uniqKey="Bone Lepinoy M" first="Marie-Christine" last="Bône-Lepinoy">Marie-Christine Bône-Lepinoy</name><name sortKey="Collin, Francoise" sort="Collin, Francoise" uniqKey="Collin F" first="Françoise" last="Collin">Françoise Collin</name><name sortKey="Cuisenier, Jean" sort="Cuisenier, Jean" uniqKey="Cuisenier J" first="Jean" last="Cuisenier">Jean Cuisenier</name><name sortKey="D Ombres, Anne" sort="D Ombres, Anne" uniqKey="D Ombres A" first="Anne" last="D Ombres">Anne D Ombres</name><name sortKey="Douvier, Serge" sort="Douvier, Serge" uniqKey="Douvier S" first="Serge" last="Douvier">Serge Douvier</name><name sortKey="Fraisse, Jean" sort="Fraisse, Jean" uniqKey="Fraisse J" first="Jean" last="Fraisse">Jean Fraisse</name><name sortKey="Horiot, Jean Claude" sort="Horiot, Jean Claude" uniqKey="Horiot J" first="Jean-Claude" last="Horiot">Jean-Claude Horiot</name><name sortKey="Magnin, Valerie" sort="Magnin, Valerie" uniqKey="Magnin V" first="Valérie" last="Magnin">Valérie Magnin</name><name sortKey="Padeano, Marie Martine" sort="Padeano, Marie Martine" uniqKey="Padeano M" first="Marie-Martine" last="Padeano">Marie-Martine Padeano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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