Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer

Present study was designed to evaluate potential risks and benefits of adjuvant radiotherapy in selected patients with intermediate-risk endometrial cancer. A total of 100 patients with stage IB grade II endometrial cancer followed up in Radiation Oncology Clinic at Dr. Lutfi Kirdar Training and Research Hospital were evaluated retrospectively to determine the influence of postsurgical adjuvant radiotherapy on disease-free survival, local recurrences and locally-relaps free survival. Side effects related to adjuvant radiotherapy were also evaluated. Forty-seven (47%) patients were determined to undergo total abdominal hysterectomy + bilateral salphingo-oopherectomy and 53 (53%) patients, total abdominal hysterectomy + bilateral salphingo-oopherectomy + pelvic lymph node dissection. Postsurgical adjuvant radiotherapy was administered in 77 patients (77%), while the surgery was the sole medical intervention for 23 patients (23%). The median follow-up period was 40.5 months (range: 6-139) Five-year disease-free survival (96.6% vs. 80.5%; p< 0.01) and local control (98.6% vs. 80.5%; p<0.05) were better in patients who were administered postoperative radiotherapy compared to patients without postoperative radiotherapy. In conclusion, while our results concerning homogenous sub-population of patients with stage IB grade II endometrial cancer seem to support the use of postoperative adjuvant radiotherapy, larger and more detailed prospective studies are required for determination of its exact prognostic value.