The use of adjuvant radiation therapy in early endometrial cancer by members of the Society of Gynecologic Oncologists in 2005

Abstract

Objectives: To determine current patterns of care for early stage endometrial cancer by the members of the Society of Gynecologic Oncologists (SGO).

Methods: A survey detailing the use of adjuvant radiation in early stage endometrial cancer was conducted. Details of surgery, indications for staging, and use of adjuvant radiation for cases primarily seen by the respondent and for those cases referred postoperatively without staging information were collected and compared to a similar survey from 1999.

Results: The practice demographics of the respondents are similar to the 1999 survey. SGO members are now more likely to perform complete surgical staging during all surgeries for endometrial cancer than in 1999 (71% vs. 48%; P<0.0001). A higher percentage of respondents now describe surgery as a complete lymphadenectomy (76% vs. 44%: P<0.0001) and believe this is therapeutic (71% vs. 66%: P=0.04). Approximately half of SGO members now use laparoscopic assisted staging in the primary treatment of endometrial cancer. Since 1999, there is a significant decrease in the recommendation for postoperative RT. In almost all cases where RT is recommended, the use of vaginal RT is now more common than pelvic RT. In all situations, consult recommendations for additional intervention were more likely if complete surgical staging had not been performed, suggesting that all patients with endometrial cancer would benefit from surgery by a gynecologic oncologist.

Conclusions: There is an increase in complete surgical staging of endometrial cancer, an increase in the use of laparoscopy, and a marked decrease in the use of pelvic RT since 1999.