Adjuvant chemotherapy including cisplatin in endometrial carcinoma

To determine the outcome of patients with endometrial endometrioid adenocar cinoma following adjuvant chemotherapy, CAP (cyclophosphamide, pirarubicin and cisplatin) and EP (etoposide and cisplatin) were assigned at random to patients with Ic or more advanced stage carcinoma, and their efficacy was c ompared. These patients were treated by the Tokai Endometrial Cancer Study Group (Nagoya University and related institutions) between January 1992 and June 1996. The 5-year survival rate was 88.4% in the CAP group and 95.1% i n the EP group; the difference between the two groups was not significant ( p = 0.3496). The disease-free survival rate was 80.3% in the CAP group and 84.8% in the EP group (nonsignificant: p = 0.4533), However, the 5-year dis ease-free survival rates were 95.1 acid 71.0% in patients with preoperative CA125 levels < 35 and greater than or equal to 35 IU/ml, and there was a s ignificant difference in disease-free survival curves (p < 0.05). A signifi cant difference was also observed in disease-free survival curves between p atients with and without pelvic lymph node metastasis (5-year disease-free survival rate: 68.8 and 88.2% in patients with and without pelvic lymph nod e metastasis, respectively, p < 0.05). Multivariate analysis of disease-fre e survival showed that the preoperative CA125 level, and pelvic lymph node metastasis were significant risk factors for recurrence. In conclusion, the EP chemotherapy had no significant advantage in terms of survival and dise ase-free survival compared to CAP, although these rates were superior in th a EP group compared to the CAP group. Copyright (C) 2000 S. Karger AG, Bas el.