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Prognostic significance of adjuvant chemotherapy in stage I–II endometrial carcinoma patients who underwent lymphadenectomy

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Abstract

Background

Endometrial carcinoma, the most common gynecologic carcinoma, has an excellent prognosis post-surgery when diagnosed early. The role of postoperative adjuvant chemotherapy in stages I–II endometrial carcinoma remains controversial. This study assesses the efficacy of adjuvant chemotherapy in improving prognosis for these patients.

Methods

A retrospective analysis was conducted on 1223 stage I–II endometrial carcinoma patients who underwent surgical treatment including total hysterectomy, bilateral sal**o-oophorectomy, and lymph-node biopsy or dissection across four Jikei University School of Medicine-affiliated facilities between 2001 and 2018. Patients were divided into low intermediate risk (LIR) and high intermediate risk (HIR) groups based on recurrence risk. Propensity score matching adjusted for various covariates was used to compare progression-free survival (PFS) and overall survival (OS) between patients who received adjuvant chemotherapy and those who did not.

Results

The study included 443 eligible patients, with 288 in the LIR group and 155 in the HIR group. Post propensity score matching, no significant difference in PFS or OS was observed between the observation and adjuvant chemotherapy groups within both risk categories. Notably, the 5-year OS for LIR was 97.6% in the observation group and 96.7% in the chemotherapy group; for HIR, the 5-year OS was similarly high with no significant difference.

Conclusions

The findings suggest that postoperative adjuvant chemotherapy does not significantly contribute to the improvement of recurrence or prognosis in patients with stage I–II endometrial carcinoma who are categorized outside the low-risk group and have no lymph-node metastasis.

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Acknowledgements

We gratefully acknowledge the cooperation of the participating hospitals affiliated with the Department of Obstetrics and Gynecology in The Jikei University School of Medicine and the gynecologic doctors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Jiro Suzuki, Hiroshi Tanabe, Yuki Koike, Misato Kamii, Kazuaki Takahashi, Masataka Takenaka, Motoaki Saito, Hirokuni Takano, Kyosuke Yamada & Aikou Okamoto

  2. Department of Gynecology, National Cancer Center Hospital East, Chiba, Japan

    Hiroshi Tanabe

  3. Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8642, Japan

    Hirofumi Michimae

Authors
  1. Jiro Suzuki
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Contributions

Conceptualization: J.S., M.T. Data curation: J.S., Y.K., M.K., K.T. Formal analysis: J.S., H.M. Methodology: M.T. Project administration: J.S., H.T. Supervision: A.O. Writing — original draft: J.S. Writing — review and edition: H.T., H.M., M.S., H.T., K.Y., A.O.

Corresponding author

Correspondence to Jiro Suzuki.

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The authors have no conflicts of interest, sources of financial support, corporate involvement, or patent holdings to disclose concerning this study.

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Suzuki, J., Tanabe, H., Michimae, H. et al. Prognostic significance of adjuvant chemotherapy in stage I–II endometrial carcinoma patients who underwent lymphadenectomy. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02560-w

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