Prognostic factors and treatment outcomes in patients with operated endometrial cancer: analysis of 674 patients at a single institution.

PURPOSE: Endometrial carcinoma is the most prevalent gynecologic tumor in developed countries. The aim of the present study was to evaluate the clinical characteristics of the patients with endometrial cancer. METHODS: Six hundred and seventy-four patients who had received postoperative therapy were retrospectively investigated. Of the cases, 186 were only monitored, whereas 43 received intracavitary radiotherapy (ICRT) and 54 external beam radiotherapy (EBRT). Two hundred and fifty-nine patients received both EBRT plus ICRT. Eight patients received chemotherapy (CT), whereas 24 patients received both CT and EBRT plus ICRT. RESULTS: Statistical analyses revealed that age, menopausal status, tumor histology, stage, grade, tumor diameter, myometrial invasion, lymphovascular space invasion (LVI), positive cytology of abdominal fluid/washings, omental involvement, adnexal involvement and the type of the therapy significantly affected both the overall survival (OS) and disease- free survival (DFS). Survival was poor in patients over 60 years of age, who had advanced stage (higher than FIGO stage 2a), grade III tumor and myometrial invasion >50%. CONCLUSION: Age was the most important factor associated with local relapse while survival was affected by age, grade, myometrial invasion and stage.

Postoperative chemoradiation in patients with localized gastric adenocarcinoma: single center experience.

BACKGROUND: 5-Fluorouracil (FU)-based chemotherapy (CT) and concurrent 45 Gy radiotherapy (RT) is one of the standard postoperative approaches currently used in gastric carcinoma. The high toxicity rates of this treatment leads to interruption of treatment in the majority of patients. In our study, we investigated the rates of toxicity and treatment discontinuation observed during postoperative FU-based chemoradiotherapy (CRT); retrospectively evaluated the effect of CRT and the other prognostic factors on local and distant control and survival. PATIENTS AND METHODS: A total of 160 patients consisting of 97 total and 63 subtotal gastrectomy receiving postoperative CRT, have been studied retrospectively. RESULTS: Patients who had to discontinue the treatment for a median of 6 (range, 3-13) days experienced toxicity during treatment at a rate of 43%. During the 21 (range, 4-68) months of follow-up local recurrences were observed in 8 (5%) patients and distant recurrences were observed in 41 (25.6%) patients. While the 1-3 year overall survival (OS) rates were 75% and 42%, 13-year disease-free survival (DFS) rates were 63% and 42%, respectively. In the univariate analysis for OS and DFS demonstrated statistical significance for below those 60 years of age, D1-D2 dissection type, negative surgical margin, early treatment beginning, the absence of invasion, and early stage disease. D1D2 dissection type, early treatment beginning, age below 60 years and early stage disease significantly improve OS and DFS in multivariate analysis. CONCLUSIONS: Survival is worse in patients older than 60 years, had late treatment beginning, advanced stage and D0 dissection.

Radiotherapy for stage I seminoma of the testis.

BACKGROUND: After orchiectomy in stage I seminoma the standard is adjuvant radiation therapy. We analyzed the patients retrospectively to evaluate the contributions of the treatment volume and dosage to treatment outcomes. MATERIALS AND METHODS: Between January 1999 and December 2005, 91 stage I seminoma patients with a median age 36 (range;22-62) applied to our center, who were treated using anterior-posterior parallel opposed fields with linear accelerator or Co60 after orchiectomy. Twenty-five (27.5%) patients received irradiation to the paraaortic and ipsilateral pelvic nodes, and 66 (62.5%) patients only received to paraaortic nodes. RESULTS: With a follow up time of median 57 months (range; 27-104), paraaortic nodes treated group had 4 relapses (6%) - 3 of them pelvic, one of them both pelvic and paraaortic. Both paraaortic and ipsilateral nodes irradiated patients had only one relapse (4%) (P = 0.726). While the 5 year overall survival (OS) is 98.8%, it is 100% in the dog-leg group and 98.4% in the paraaortic group (P = 0.548). Univariate analyses of OS and Disease Free Survival (DFS) showed that there is no statistically significant difference related to factors as age, histologic subgroup, tumor size, rete testis involvement, radiotherapy (RT) fields, dose ranges and the therapy device. CONCLUSION: Adjuvant RT approach is the preferred for non-compliant low risk patients as well as intermediate and high risk patient in stage I seminoma. 20 Gy/ 10 fractions/ 2 weeks RT is the adequate treatment.

A retrospective comparison of concurrent 5-fluorouracil or oral UFT in postoperative chemoradiation for gastric adenocarcinoma.

PURPOSE: 5-fluoro-uracil (FU) is a common agent in postoperative chemoradiation in gastric adenocarcinoma. However, FU is not well tolerated in a significant proportion of patients. UFT, a fixed combination of the oral FU prodrug tegafur with uracil, is one of the agents used instead of FU in such cases. We retrospectively compared the toxicity, local and distant control and survival rates with FU or oral UFT during concurrent radiotherapy to assess the role of UFT instead of FU. PATIENTS AND METHODS: We conducted a retrospective analysis of survival, disease control and toxicity data in 52 patients treated with postoperative chemoradiation following total or subtotal gastrectomy for gastric adenocarcinoma with either FU or UFT between January 2003 and December 2004. RESULTS: Median follow-up was 20 months (range: 3-59), median survival time was 23 (+/-6.08) months and 1-3 years overall survival (OS) rates were 64.9-39% for all patients. Compared with the UFT regimen, the incidence of treatment interruption was greater with FU (p=0.023), but no significant differences were seen in local control (p=0.40), distant recurrences (p=0.83) and survival rates (p=0.8657) among patients. CONCLUSION: Concurrent UFT with radiotherapy seems to be a more tolerable and an equally effective regimen in the postoperative treatment of gastric adenocarcinoma when compared to FU.