Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 33A - What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
Sandwich Therapy
from Section IV - Endometrial Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
High-risk endometrial cancer represents a heterogenous group of patients, including nonendometroid tumor types such as serous carcinoma, that are characterized by poorer overall survival, most likely due to higher rates of distant metastasis. For this reason, adjuvant chemotherapy can be considered in this particular population.Unfortunately, as these tumors represent an infrequent subset of patients, data are very limited.
A subgroup analysis of the NSGO9501/EORTC 55991 and MaNGO-ILIADE III trials did not show a survival benefit for patients with serous or clear-cell tumors. Data from retrospective analysis suggest that, in patients who did not undergo complete surgical staging, adjuvant therapy was associated with greater oncological outcomes.
In conclusion, adjuvant therapy should be considered in non-staged patients, when complete surgical staging is not feasible or within clinical trials. Future prospective clinical trials, including the constantly evolving molecular categorization, are needed to explore more effective treatment strategy for this unique patient population.
- Type
- Chapter
- Information
- 50 Big Debates in Gynecologic Oncology , pp. 198 - 201Publisher: Cambridge University PressPrint publication year: 2023
References
de Boer, SM, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol 2018;19(3):295–309.CrossRefGoogle ScholarPubMed
Secord, AA, et al. A multicenter evaluation of adjuvant therapy in women with optimally resected stage IIIC endometrial cancer. Gynecol Oncol 2013;128(1):65–70.CrossRefGoogle ScholarPubMed
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Frimer, M, et al. Adjuvant pelvic radiation “sandwiched” between paclitaxel/carboplatin chemotherapy in women with completely resected uterine serous carcinoma: long-term follow-up of a prospective phase 2 trial. Int J Gynecol Cancer 2018;28(9):1781–1788.CrossRefGoogle ScholarPubMed