Secord AA et al. (2007) The role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer. Gynecol Oncol 107: 285–291

Early-stage endometrial cancer has an excellent prognosis; however, the survival rates for patients with advanced disease remain very low and an optimum management strategy has yet to be defined. A study by Secord et al. has evaluated the influence of combined adjuvant therapy on the survival of patients with advanced endometrial cancer.

This retrospective study included 356 patients with stage III or IV cancer, of whom 83% were optimally debulked and 17% received suboptimal cytoreduction. Postoperative radiotherapy alone and chemotherapy alone was administered to 48% and 29% of patients, respectively, while 23% of patients received combined chemotherapy and radiation. Overall survival (OS) and progression-free survival differed significantly between the three groups (P <0.001). Patients who received chemotherapy alone had worse 3-year OS and progression-free survival (33% and 19%, respectively) than did patients who received radiotherapy alone (70% and 59%) or patients who received combined therapy (79% and 62%). In comparison with the combined-therapy group, the adjusted hazard ratio (HR) for OS was 2.01 (P = 0.012) for the radiotherapy group and 1.60 (P = 0.122) for the chemo-therapy group. Optimally debulked patients who received either radiotherapy or chemotherapy alone had significantly higher risks for disease progression (HR = 1.80 and HR = 1.84, respectively; P <0.05 for both) and death (HR = 2.64; P = 0.004 and HR = 2.33; P = 0.024) than did patients who received combined therapy.

The authors conclude that combined chemotherapy and radiation treatment increases survival in patients with advanced endometrial cancer compared with use of either modality alone.