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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)
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author
; ; ; ; ; ; and
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
BMJ Publishing Group
external identifiers
  • wos:000221794500004
  • scopus:2942622416
ISSN
1048-891X
DOI
10.1111/j.1048-891x.2004.014303.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Obstetrics and Gynaecology (Lund) (013018000), Oncology, MV (013035000), Pathology, (Lund) (013030000)
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
2016-04-01 12:21:24
date last changed
2022-07-15 08:49:14
@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}},
  keywords     = {{prospective studies; endometrial neoplasms/therapy; ploidies; risk; factors}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{437--450}},
  publisher    = {{BMJ Publishing Group}},
  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}},
  doi          = {{10.1111/j.1048-891x.2004.014303.x}},
  volume       = {{14}},
  year         = {{2004}},
}