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Article

Neoadjuvant Chemotherapy Followed by Surgery for Advanced-Stage Endometrial Cancer

by
N.M. de Lange
1,*,
N.P.M. Ezendam
2,
J.S. Kwon
3,
I. Vandenput
4,
D. Mirchandani
5,
F. Amant
6,7,
L.J.M. van der Putten
8 and
J.M.A. Pijnenborg
9,10
1
Formerly: Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, Eindhoven, Netherlands; Currently: Department of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, The Netherlands
2
Tilburg University and Comprehensive Cancer Centre, Tilburg, The Netherlands
3
Department of Obstetrics and Gynaecology, BC Cancer, University of British Columbia, Vancouver, BC, Canada
4
Department of Obstetrics and Gynaecology, AZ Turnhout, Turnhout, Belgium
5
Department of Oncology, BC Cancer–Sindi Ahluwalia Hawkins Centre for the Southern Interior, Kelowna, BC, Canada
6
Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium
7
Centre for Gynaecologic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
8
Formerly: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands; Currently: Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands
9
Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands
10
Radboud Institute for Health Sciences, Nijmegen, The Netherlands
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2019, 26(2), 226-232; https://doi.org/10.3747/co.26.4655
Submission received: 5 January 2019 / Revised: 5 February 2019 / Accepted: 5 March 2019 / Published: 1 April 2019

Abstract

Background: Data showing the value of neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in the management of advanced-stage serous endometrial carcinoma (ECA) are limited; the aim of the present study was to expand the knowledge about that treatment strategy in patients with advanced ECA, including endometrioid ECA. Methods: Data were collected retrospectively from all patients with advanced-stage eca treated with NACT between 2005 and 2014 at 3 oncology referral centres. Primary outcomes were the radiologic response to nact and achievement of optimal or complete IDS. Secondary outcomes were recurrence rate and progression-free and overall survival. Results: Of 102 ECA cases included, a complete radiologic response was achieved in only 4 cases, with a partial response being achieved in 72% (64% of endometrioid cases, 80% of serous cases). Complete IDS was achieved in 62% of the endometrioid cases and in 56% of the serous ECA cases, with optimal IDS achieved in 31% and 28% of those cases respectively. Survival rates were calculated for all patients with complete and optimal IDS; recurrence was observed in 56% and 67% of the cases respectively, and progression-free survival was 18 months and 13 months respectively. Median survival duration was 24 months for endometrioid ECA and 28 months for serous ECA. Conclusions: For patients with advanced ECA who are not suitable for primary debulking, NACT followed by IDS can be considered regardless of histologic subtype. The treatment options for this group of patients are limited and have to be explored.
Keywords: endometrial cancer; advanced; neoadjuvant chemotherapy; radiologic response; interval debulking surgery endometrial cancer; advanced; neoadjuvant chemotherapy; radiologic response; interval debulking surgery

Share and Cite

MDPI and ACS Style

de Lange, N.M.; Ezendam, N.P.M.; Kwon, J.S.; Vandenput, I.; Mirchandani, D.; Amant, F.; van der Putten, L.J.M.; Pijnenborg, J.M.A. Neoadjuvant Chemotherapy Followed by Surgery for Advanced-Stage Endometrial Cancer. Curr. Oncol. 2019, 26, 226-232. https://doi.org/10.3747/co.26.4655

AMA Style

de Lange NM, Ezendam NPM, Kwon JS, Vandenput I, Mirchandani D, Amant F, van der Putten LJM, Pijnenborg JMA. Neoadjuvant Chemotherapy Followed by Surgery for Advanced-Stage Endometrial Cancer. Current Oncology. 2019; 26(2):226-232. https://doi.org/10.3747/co.26.4655

Chicago/Turabian Style

de Lange, N.M., N.P.M. Ezendam, J.S. Kwon, I. Vandenput, D. Mirchandani, F. Amant, L.J.M. van der Putten, and J.M.A. Pijnenborg. 2019. "Neoadjuvant Chemotherapy Followed by Surgery for Advanced-Stage Endometrial Cancer" Current Oncology 26, no. 2: 226-232. https://doi.org/10.3747/co.26.4655

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