Is there a survival benefit to adjuvant radiotherapy in high-risk surgical XXXX ?

@entity1204 @entity1 @entity4348 @entity5
OBJECTIVE: The aim of this study was to examine the effects of therapeutic modalities on survival of @entity1204 and also to evaluate the surgical morbidity and the prognostic importance of surgicopathological variables. METHODS: A hundred and ninety-six @entity1204 @entity1 treated at Hacettepe University Hospital between 1982 and 1997 were included. After initial diagnosis all @entity1 underwent surgical procedures including peritoneal cytology, infracolic omentectomy, total abdominal hysterectomy, bilateral salphingoopherectomy, and complete pelvic-paraaortic lymphadenectomy. The mean age at initial diagnosis was 56 years (SD = 9.9 years) and the @entity1 were followed 3-18 years (median, 8 years). All @entity1 had @entity4348 . Stage IC and/or grade 3 @entity5 were considered high-risk factors and by this definition 147 (75%) @entity1 were low risk and 49 (25%) @entity1 were high risk. Forty-nine percent of high-risk @entity1 received adjuvant radiotherapy compared with 3.5% of @entity1 in the low-risk group. RESULTS: The 10-year disease-free and overall survival rates of the entire group were 97 and 98%, respectively. Ten-year overall survival rate for the low-risk group was 100% compared with 94% for @entity1 with high-risk features (P = 0.002). The 10-year disease-free survival rate in the high-risk group was 96% for 24 @entity1 who received adjuvant radiotherapy versus 92% for 25 @entity1 who did not receive adjuvant therapy (P = 0.53). Only high grade was a significant predictor of poor survival (P = 0.0004). Overall surgical morbidity rate was 8.1% without mortality related to surgery. CONCLUSIONS: Surgical staging achieved excellent survival for @entity1204 @entity1 without incurring untoward morbidity and mortality. No survival advantage of adjuvant radiotherapy was detected even for high-risk @entity1 , so we suggest the use of radiotherapy may be reserved for relapse.
