(P076) Postoperative Treatment Recommendations for Stage I Endometrial Cancer: A Survey of Society of Gynecologic Oncology Members

April 30, 2015

BT is the most common AT modality recommended by SGO members in the postoperative management of stage I EC. CT was recommended in a substantial number of scenarios and even exceeded the use of EBRT in G3 disease. Although there was generally agreement about the management of low-risk EC, there was much more variability in high-intermediate–risk patients. Further studies are needed to compare these SGO members’ recommendations with those of radiation oncologists and to determine optimal management.

Brian S. De, BA, Elena Pereira, MD, Valentin Kolev, MD, Konstantin Zakashansky, MD, Peter R. Dottino, MD, Sheryl Green, MD, Vishal Gupta, MD; Icahn School of Medicine at Mount Sinai

OBJECTIVES: To assess postoperative adjuvant therapy (AT) recommendations for International Federation of Gynecology and Obstetrics (FIGO) stage I endometrioid endometrial cancer (EC) among members of the Society of Gynecologic Oncology (SGO).

METHODS: A 19-question survey was developed, approved by our institutional review board, and emailed to SGO members. Data were collected anonymously using Internet-based survey software. Demographic questions included specialty, years in practice, practice setting, and EC patient volume. Respondents were asked questions regarding preoperative workup, surgical approach, lymph node dissection (LND), and AT based on various clinicopathologic scenarios. AT options included no further treatment or any combination of brachytherapy (BT), external beam radiotherapy (EBRT), and/or chemotherapy (CT). Here, we report the results of AT recommendations. Statistical analysis was performed using Statistical Package for the Social Sciences version 22.0 (SPSS v22.0).

RESULTS: Of the 1,399 SGO members, 320 (23%) completed the survey: 97% of respondents were gynecologic oncologists or fellows, and 2% were radiation oncologists; 49% of respondents had > 10 years of experience, 81% practiced at a university hospital or a community hospital with an academic affiliation, and 87% treated > 30 EC patients yearly. As expected, AT was chosen more frequently with greater myometrial invasion, higher tumor grade (G), and lymphovascular invasion (LVI). Respondents typically did not select any AT for stage IA, G1–2 without LVI. For stage IA, G3, +LVI disease, respondents chose BT only (55%), BT + CT (16%), BT + EBRT (7%), EBRT only (5%), CT only (5%), or no further therapy (8%); used alone or in combination, respondents most frequently selected BT (82%), followed by CT (24%) and EBRT (15%). For stage IB, G3, +LVI disease, respondents chose BT only (29%), BT + CT (27%), EBRT only (13%), BT + EBRT (10%), CT only (8%), BT + EBRT + CT (6%), EBRT + CT (5%), or no further therapy (2%); used alone or in combination, respondents most frequently selected BT (73%), followed by CT (48%) and EBRT (34%). A total of 70% of respondents considered age when planning treatment. Older patients were recommended to have AT, particularly BT, in earlier stages of disease, with similar use of CT and EBRT.

CONCLUSIONS: BT is the most common AT modality recommended by SGO members in the postoperative management of stage I EC. CT was recommended in a substantial number of scenarios and even exceeded the use of EBRT in G3 disease. Although there was generally agreement about the management of low-risk EC, there was much more variability in high-intermediate–risk patients. Further studies are needed to compare these SGO members’ recommendations with those of radiation oncologists and to determine optimal management.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org