Endometrial cancer stage II: 190 cases with different preoperative irradiation

In a retrospective study, the 5-year survival in 190 patients with endometrial adenocarcinoma stage II was evaluated in relation to different preoperative radiotherapy techniques. In one group, group A, 111 patients received low dose rate radium to the cervix region and in a second group, group B, 79 patients received high dose rate 60Co treatment using the after-loading technique. Both groups received intracavitary radium using the standard Heyman technique. There were no statistically significant differences in survival, after correction for intercurrent disease, between the two groups. The overall 5-year survival corrected by intercurrent disease was 79% for group A and 80% for group B. The histological grade survival in group A was 94% in grade 1, 83% in grade 2, and 60% in grade 3 and in group B, 100% in grade 1, 80% in grade 2, and 59% in grade 3. A correlation was found between histological grade, uterine sound, and survival in both groups. Only in grade 3 was deep infiltration found to have a worse prognosis. No metastasis in regional lymph nodes was found, but distant metastasis was a problem in grade 3. A significant overrepresentation of nullipara could be found among the 190 patients and was pronounced for grade 1. Our results indicate that vaginal radium application can be replaced by high dose rate 60Co in the treatment of stage II endometrial adenocarcinoma, with no decrease in the 5-year survival rate.