The role of adjuvant radiation in uterine XXXX .

@entity1 @entity242 @entity5 @entity1753 @entity6019 @entity1822 @entity6962 @entity1349
PURPOSE: To determine clinical and pathological factors significant for @entity1349 ( @entity1349 ) and local-regional failure-free survival (LRFFS) in uterine @entity242 as they relate to @entity1753 ( @entity1753 ). METHODS AND MATERIALS: A retrospective analysis of 3,650 @entity1 with uterine @entity242 was conducted using the National Oncology Database, a proprietary database of aggregated @entity5 registries owned by Impac Medical Systems (Sunnyvale, CA). Adjuvant radiotherapy was defined as postoperative external beam radiation to the pelvis, with or without brachytherapy. Prognostic factors were identified by multivariate analysis (MVA) using the Cox proportional hazards model. The Kaplan-Meier method was used to estimate survival, with significant differences (p < 0.05) determined using the log-rank test. RESULTS: The median follow-up time was 59 months, with a 5-year @entity1349 of 37%. Significant prognostic factors for @entity1349 were stage, race/ethnicity, grade, age, histology, lymph node status, and surgical treatment (p < 0.01 for all factors). Use of @entity1753 was not predictive for @entity1349 . For nonmetastatic @entity5 @entity1 receiving definitive surgery (n = 2,206), the 5-year LRFFS was 87%. In this group, stage, grade, histology, and @entity1753 were prognostic for LRFFS (p < 0.05), with @entity1753 associated with improved outcome compared with surgery alone (hazard ratio = 0.4, p < 0.001). @entity1 with @entity6962 , @entity6019 , @entity1822 , poorly differentiated @entity5 , and negative lymph nodes had reduced local-regional failure (LRF) with @entity1753 (log-rank, p < 0.05 for all). CONCLUSION: In the largest retrospective analysis of uterine @entity242 published thus far, @entity1753 conferred a 53% reduction in the risk of LRF at 5 years. Use of @entity1753 may have broader indications than what are currently accepted in clinical practice.
