Good Outcomes of Patients with Stage IB Endometrial Cancer with Surgery Alone


Background: Most patients with endometrial cancer have stage I disease. Adjuvant therapy in stage IB(formerly IC) endometrial cancer is controversial, treatment options including observation or brachytherapy/radiotherapy in grade 1-3 patients with or without chemotherapy. The purpose of this study was to assessthe outcomes of our patients with stage IB endometrioid endometrial cancer. Materials and
Methods: Sixtytwo patients with stage IB endometrial cancer and endometrioid histology were retrospectively evaluated. Allpatients were initially treated surgically by the same surgeon with comprehensive staging, i.e. total abdominalhysterectomy, bilateral salphingooopherectomy, bilateral pelvic and paraaortic lymph node dissection andomentectomy. Adjuvant radiotherapy was discussed with patients and utilized by those who accepted. Adjuvantchemotherapy was not given to any of the patients.
Results: Median age was 62 (range, 42-95). Ninety percentof the patients had grade 1-2 disease. Thirteen patients (21%) received intra vaginal brachytherapy (IVBT) andone received whole pelvic radiotherapy (WPRT). Median follow-up time was 46 months (range, 9-77 months).Three patients experienced recurrence (4.8%), two of them died on follow-up and one was still alive at last visit.Two patients with recurrence had FIGO grade 2 tumors and one had a grade 3 tumor. Two patients (3.2%)died without evidence of recurrent disease. Relapse free survival at 5 years was 94.4% and overall survival was93.1%.
Conclusions: Patients with stage IB disease in our study demonstrated relatively low recurrence rates although the majority of them received no adjuvant treatment. Surgery alone may be sufficient for most patients with this stage of endometrial cancer.