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A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer

Hogberg, T; Fredstorp-Lidebring, M; Alm, Per LU ; Baldetorp, Bo LU ; Larsson, G; Ottosen, C; Svanberg, L and Lindahl, Bengt LU (2004) In International Journal of Gynecological Cancer 14(3). p.437-450
Abstract
A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n = 553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n = 283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI =... (More)
A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n = 553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n = 283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI = 93-98%) was identified. The high-risk group (n = 52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI = 65-89%). The difference in survival between the groups was highly significant (P < 0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prospective studies, endometrial neoplasms/therapy, ploidies, risk, factors
in
International Journal of Gynecological Cancer
volume
14
issue
3
pages
437 - 450
publisher
Wiley-Blackwell
external identifiers
  • wos:000221794500004
  • scopus:2942622416
ISSN
1048-891X
DOI
10.1111/j.1048-891x.2004.014303.x
language
English
LU publication?
yes
id
77ba57b2-dd29-4332-bfd3-8695f46242c7 (old id 276230)
alternative location
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=15228416&dopt=AbstractPlus
date added to LUP
2007-08-02 15:37:57
date last changed
2017-12-10 03:51:58
@article{77ba57b2-dd29-4332-bfd3-8695f46242c7,
  abstract     = {A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n = 553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n = 283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI = 93-98%) was identified. The high-risk group (n = 52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI = 65-89%). The difference in survival between the groups was highly significant (P &lt; 0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.},
  author       = {Hogberg, T and Fredstorp-Lidebring, M and Alm, Per and Baldetorp, Bo and Larsson, G and Ottosen, C and Svanberg, L and Lindahl, Bengt},
  issn         = {1048-891X},
  keyword      = {prospective studies,endometrial neoplasms/therapy,ploidies,risk,factors},
  language     = {eng},
  number       = {3},
  pages        = {437--450},
  publisher    = {Wiley-Blackwell},
  series       = {International Journal of Gynecological Cancer},
  title        = {A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer},
  url          = {http://dx.doi.org/10.1111/j.1048-891x.2004.014303.x},
  volume       = {14},
  year         = {2004},
}