TY - JOUR
T1 - Health related quality of life and symptoms after pelvic lymphadenectomy or radiotherapy vs. no adjuvant regional treatment in early-stage endometrial carcinoma: A large population-based study
AU - van de Poll-Franse, Lonneke V.
AU - Pijnenborg, Johanna M. A.
AU - Boll, Dorry
AU - Vos, M. Caroline
AU - van den Berg, Hetty
AU - Lybeert, Marnix L. M.
AU - de Winter, Karin
AU - Kruitwagen, Roy F. P. M.
PY - 2012/10
Y1 - 2012/10
N2 - Objectives. Routine lymphadenectomy (LA) in early stage endometrial cancer does not improve survival. However, in the absence of lymph node metastasis, radiotherapy (RT) could be withheld and hence could result in less morbidity. Our aim was to evaluate health related quality of life (HRQL) in endometrial cancer survivors that received routine pelvic LA without RT compared to no LA, but RT in the presence of risk factors. Methods. Stage I-II endometrial cancer survivors diagnosed between 1999 and 2007 were selected from the Eindhoven Cancer Registry. Survivors completed the SF-36 and the EORTC-QLQ-EN24. ANCOVA and multiple linear regression analyses were applied. Results. 742 (77%) of the endometrial cancer survivors returned a completed questionnaire. 377 (51%) had received no LA nor RT (LA-RT-), 198 (27%) had received LA+RT-, 153 (21%) LA-RT+ and 14 patients (2%) had received both. LA+ women reported as higher lymphedema symptom scores (25 vs. 20, p = 0.04). Women who were treated with RT reported higher gastrointestinal symptom scores vs. those who did not (23 vs. 16, p = 0.04). HRQL scales were comparable between all four treatment groups. Conclusion. Despite distinct symptom patterns among women who received LA or RT, no clinically relevant differences in HRQL were observed when compared to women not receiving adjuvant therapy. Using LA to tailor adjuvant pelvic radiotherapy and prevent over-treatment in low-risk patients cannot be recommended.
AB - Objectives. Routine lymphadenectomy (LA) in early stage endometrial cancer does not improve survival. However, in the absence of lymph node metastasis, radiotherapy (RT) could be withheld and hence could result in less morbidity. Our aim was to evaluate health related quality of life (HRQL) in endometrial cancer survivors that received routine pelvic LA without RT compared to no LA, but RT in the presence of risk factors. Methods. Stage I-II endometrial cancer survivors diagnosed between 1999 and 2007 were selected from the Eindhoven Cancer Registry. Survivors completed the SF-36 and the EORTC-QLQ-EN24. ANCOVA and multiple linear regression analyses were applied. Results. 742 (77%) of the endometrial cancer survivors returned a completed questionnaire. 377 (51%) had received no LA nor RT (LA-RT-), 198 (27%) had received LA+RT-, 153 (21%) LA-RT+ and 14 patients (2%) had received both. LA+ women reported as higher lymphedema symptom scores (25 vs. 20, p = 0.04). Women who were treated with RT reported higher gastrointestinal symptom scores vs. those who did not (23 vs. 16, p = 0.04). HRQL scales were comparable between all four treatment groups. Conclusion. Despite distinct symptom patterns among women who received LA or RT, no clinically relevant differences in HRQL were observed when compared to women not receiving adjuvant therapy. Using LA to tailor adjuvant pelvic radiotherapy and prevent over-treatment in low-risk patients cannot be recommended.
KW - Endometrial cancer
KW - Pelvic lymphadenectomy
KW - Radiotherapy
KW - Symptoms
KW - Health related quality of life
KW - EORTC QLQ-EN24
U2 - 10.1016/j.ygyno.2012.06.007
DO - 10.1016/j.ygyno.2012.06.007
M3 - Article
C2 - 22704950
SN - 0090-8258
VL - 127
SP - 153
EP - 160
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -