Study: Adjuvant radiotherapy reduces loco-regional failure in uterine sarcoma

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A retrospective analysis of uterine sarcoma cases, published Aug. 24 in the International Journal of Radiation Oncology*Biology*Physics, found that adjuvant radiotherapy conferred a 53 percent reduction in the risk of local-regional failure at five years.

Sagus Sampath, MD, and colleagues from the department of radiation oncology at the University of California, Davis Health System in Sacramento, Calif., sought to determine clinical and pathological factors significant for overall survival and local-regional failure-free survival in uterine sarcoma, as they relate to adjuvant radiotherapy.

The researchers conducted an analysis of 3,650 patients with uterine sarcoma using the National Oncology Database, a database of aggregated tumor registries owned by Impac Medical Systems of Sunnyvale, Calif. They defined adjuvant radiotherapy as postoperative external beam radiation to the pelvis, with or without brachytherapy.

The median follow-up time was 59 months, with a five-year overall survival of 37 percent, according to the authors. Significant prognostic factors for overall survival were stage, race/ethnicity, grade, age, histology, lymph node status and surgical treatment.

They found that use of adjuvant radiotherapy was not predictive for overall survival.

For nonmetastatic cancer patients receiving definitive surgery (2,206 patients), Sampath and colleagues found that the five-year local-regional failure-free survival rate was 87 percent. In this group, they said that stage, grade, histology and adjuvant radiotherapy were prognostic for local-regional failure-free survival, with adjuvant radiotherapy associated with improved outcome, compared with surgery alone.

Patients with carcinosarcoma, endometrial stromal sarcoma, leiomyosarcoma, poorly differentiated tumors and negative lymph nodes had reduced local-regional failure with adjuvant radiotherapy.

Based on their findings, the authors said that “use of adjuvant radiotherapy may have broader indications than what are currently accepted in clinical practice.”