Skip to main content
SpringerLink
Log in

Impact of Radical Hysterectomy on Survival in Patients with Stage 2 Type1 Endometrial Carcinoma: A Matched Cohort Study

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

In cases of stage 2 endometrial cancers (ECs), a radical hysterectomy is recommended; however, its benefits are poorly documented.

Objective

The aim of this study was to determine whether a primary radical hysterectomy improves specific and overall survival compared with a simple hysterectomy in stage 2 EC.

Methods

Data from all women with type 1 EC and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage 2 who underwent surgical treatment between January 1998 and December 2012 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Women treated with radical hysterectomy were matched with women treated with simple hysterectomy according to demographic and tumoral criteria. The primary endpoint was cancer-related survival.

Results

One-to-two matching enabled a comparison of 273 patients who underwent a radical hysterectomy for stage 2 EC (case group) with 546 patients who received a simple hysterectomy (control group). The probability of cancer-related survival was not significantly different in the case group compared with the control group (p = 0.08), and the 3-year cancer-related survivals in the radical and simple hysterectomy groups were 88.7 and 94.1 %, respectively. Following adjustment for radiation, survival analysis indicated there was no survival difference between the two groups with regard to cancer-related survival or overall survival.

Conclusion

The present study indicates that for patients with stromal cervical invasion and type 1 EC, the type of hysterectomy does not impact cancer-related or overall survival, even after adjustment for adjuvant radiation. This finding suggests that additional, randomized clinical studies are required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.

    Article  PubMed  Google Scholar 

  2. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105(2):103–4.

    Article  PubMed  Google Scholar 

  3. Creasman W. Revised FIGO staging for carcinoma of the endometrium. Int J Gynaecol Obstet. 2009;105(2):109.

    Article  PubMed  Google Scholar 

  4. Amant F, Mirza MR, Koskas M, Creutzberg CL. Cancer of the corpus uteri. Int J Gynaecol Obstet. 2015;131 Suppl 2:S96–104.

    Article  PubMed  Google Scholar 

  5. Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, et al. Endometrial cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi33–8.

  6. NCCN clinical practice guidelines in oncology (NCCN guidelines): uterine neoplasms. 2014.

  7. Boente MP, Yordan EL, McIntosh DG, Grendys EC, Orandi YA, Davies S, et al. Prognostic factors and long-term survival in endometrial adenocarcinoma with cervical involvement. Gynecol Oncol. 1993;51(3):316–22.

    Article  CAS  PubMed  Google Scholar 

  8. Sartori E, Gadducci A, Landoni F, Lissoni A, Maggino T, Zola P, et al. Clinical behavior of 203 stage II endometrial cancer cases: the impact of primary surgical approach and of adjuvant radiation therapy. Int J Gynecol Cancer. 2001;11(6):430–7.

    Article  CAS  PubMed  Google Scholar 

  9. Lee TS, Kim JW, Kim DY, Kim YT, Lee KH, Kim BG, et al. Necessity of radical hysterectomy for endometrial cancer patients with cervical invasion. J Korean Med Sci. 2010;25(4):552–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cornelison TL, Trimble EL, Kosary CL. SEER data, corpus uteri cancer: treatment trends versus survival for FIGO stage II, 1988–1994. Gynecol Oncol. 1999;74(3):350–5.

    Article  CAS  PubMed  Google Scholar 

  11. Wright JD, Fiorelli J, Kansler AL, Burke WM, Schiff PB, Cohen CJ, et al. Optimizing the management of stage II endometrial cancer: the role of radical hysterectomy and radiation. Am J Obstet Gynecol. 2009;200(4):419.e1–7.

  12. Rutledge F. The role of radical hysterectomy in adenocarcinoma of the endometrium. Gynecol Oncol. 1974;2(2–3):331–47.

    Article  CAS  PubMed  Google Scholar 

  13. Takano M, Ochi H, Takei Y, Miyamoto M, Hasumi Y, Kaneta Y, et al. Surgery for endometrial cancers with suspected cervical involvement: is radical hysterectomy needed (a GOTIC study)? Br J Cancer. 2013;109(7):1760–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Ries LAG, Kosary CL, Hankey BF, Miller BA, Edwards BK (eds). SEER cancer statistics review: 1973–1995. Bethesda, MD, National Cancer Institute; 1998.

    Google Scholar 

  15. FIGO (International Federation of Gynecology and Obstetrics). FIGO stages, 1988 revision. Gynecol Oncol 1989; 35: 125–6.

    Google Scholar 

  16. Piver MS, Rutledge F, Smith JP. Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 1974;44(2):265–72.

    CAS  PubMed  Google Scholar 

  17. Lanciano RM, Curran WJ, Greven KM, Fanning J, Stafford P, Randall ME, et al. Influence of grade, histologic subtype, and timing of radiotherapy on outcome among patients with stage II carcinoma of the endometrium. Gynecol Oncol. 1990;39(3):368–73.

    Article  CAS  PubMed  Google Scholar 

  18. Boente MP, Orandi YA, Yordan EL, Miller A, Graham JE, Kirshner C, et al. Recurrence patterns and complications in endometrial adenocarcinoma with cervical involvement. Ann Surg Oncol. 1995;2(2):138–44.

    Article  CAS  PubMed  Google Scholar 

  19. Feltmate CM, Duska LR, Chang Y, Flynn CE, Nikrui N, Kiggundu E, et al. Predictors of recurrence in surgical stage II endometrial adenocarcinoma. Gynecol Oncol. 1999;73(3):407–11.

    Article  CAS  PubMed  Google Scholar 

  20. Ayhan A, Taskiran C, Celik C, Yuce K. The long-term survival of women with surgical stage II endometrioid type endometrial cancer. Gynecol Oncol. 2004;93(1):9–13.

    Article  PubMed  Google Scholar 

  21. Cohn DE, Woeste EM, Cacchio S, Zanagnolo VL, Havrilesky LJ, Mariani A, et al. Clinical and pathologic correlates in surgical stage II endometrial carcinoma. Obstet Gynecol. 2007;109(5):1062–7.

    Article  PubMed  Google Scholar 

  22. Sharma C, Deutsch I, Lewin SN, Burke WM, Qiao Y, Sun X, et al. Lymphadenectomy influences the utilization of adjuvant radiation treatment for endometrial cancer. Am J Obstet Gynecol. 2011;205(6):562.e1–9.

  23. Parthasarathy A, Kapp DS, Cheung MK, Shin JY, Osann K, Chan JK. Adjuvant radiotherapy in incompletely staged IC and II endometrioid uterine cancer. Obstet Gynecol. 2007;110(6):1237–43.

    Article  PubMed  Google Scholar 

  24. Mariani A, Webb MJ, Keeney GL, Calori G, Podratz KC. Role of wide/radical hysterectomy and pelvic lymph node dissection in endometrial cancer with cervical involvement. Gynecol Oncol. 2001;83(1):72–80.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Bichat University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Denis Diderot, CHU Bichat Claude Bernard, 46, rue Henri-Huchard, 75018, Paris, France

    Juliette Phelippeau MD & Martin Koskas MD, PhD

  2. EA 7285, University Versailles Saint Quentin, Montigny-Le-Bretonneux, France

    Martin Koskas MD, PhD

Authors
  1. Juliette Phelippeau MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Koskas MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Koskas MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Phelippeau, J., Koskas, M. Impact of Radical Hysterectomy on Survival in Patients with Stage 2 Type1 Endometrial Carcinoma: A Matched Cohort Study. Ann Surg Oncol 23, 4361–4367 (2016). https://doi.org/10.1245/s10434-016-5372-3

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-016-5372-3

Keywords

Search

Navigation