Adjuvant chemotherapy predicts worse DFS in endometrial cancer

In patients with surgically unresectable endometrial cancer who underwent neoadjuvant chemoradiation (CRT) or radiation therapy (RT), adjuvant chemotherapy is associated with worse DFS but not with improved OS, reveals a recent study.

Of the 89 patients identified, 48 (54 percent) received adjuvant chemotherapy. No statistically significant difference was observed in OS (p=0.062) between patients who received adjuvant chemotherapy and those who did not. Notably, adjuvant chemotherapy significantly correlated with worse DFS (p=0.037).

Likewise, subgroup analysis revealed no statistically significant difference in OS or DFS in any subgroup when examining the impact of adjuvant chemotherapy.

“A larger cohort and longer follow-up are needed to ascertain whether certain high-risk subgroups of patients benefit from adjuvant chemotherapy,” the researchers said.

This retrospective, single-institution review was conducted from April 2008 to October 2021 in all patients who underwent neoadjuvant CRT or RT before surgical resection of endometrial cancer was performed.

The authors assessed the differences in OS and DFS between the group the received adjuvant chemotherapy and the group that did not using Kaplan-Meier method with log-rank test. They also performed a subgroup analysis to determine whether specific subgroups benefitted from this treatment.

“In patients with surgically unresectable disease who undergo neoadjuvant CRT or RT before surgical staging, little is known about whether adjuvant chemotherapy confers a survival benefit,” the authors said.