Study Targets Endometrial Cancer

By Lois M. Collins Deseret Morning News

Women with early-stage endometrial cancer are more likely to survive if they receive radiation therapy as part of their treatment, according to a study by Huntsman Cancer Institute researchers published Jan. 25 in the Journal of the American Medical Association.

Endometrial cancer is the most common gynecological malignancy in the United States.

The study, which was a retrospective look at what has happened to 21,249 cancer patients treated between 1988 and 2001, “is the largest reported population analysis of adjuvant radiation therapy in early endometrial cancer,” said Dr. David Gaffney, medical director of radiation oncology at the institute and principal author of the study.

The study looked at the difference in survival rates for those who received radiation as part of their treatment and those who did not.

The data the researchers analyzed came from the Surveillance, Epidemiology and End Results Program of the U.S. National Cancer Institute. Women in the study had node-negative endometrial cancer.

The findings clearly suggest the need for further study to see if factors can be detected that could help guide treatment decisions, Gaffney said. The factors that predicted poor outcome for the women in this study were “advanced age, advanced stage and advanced grade” of disease, he said.

Study subjects fell into two age groups, those 56-75 and those over 75. “The younger patients did better,” with more favorable outcomes after surgery was done to remove the malignancy, he said.

More than 80 percent of them did not receive adjuvant radiation therapy. In those who did, there was a 56 percent lower rate of death for those with grade 1 cancer, and 28 percent lower for those with grades 3 and 4, according to a JAMA summary of the study.

The researchers note that “this information should be added to previous articles in the literature that confirm beneficial effects of adjuvant RT on both local and distant tumor control for certain patient cohorts.”

But they also point out that statistics should not replace clinical judgment that is based on individual factors, including the patient, the tumor’s characteristics and potential benefits and risks of radiation therapy.

Some of the funding for the research came from a grant from the Cancer Center Support. Christopher M. Lee, a medical resident at the University of Utah School of Medicine, is the study’s first author.

E-mail: lois@desnews.com