Survival after multimodality treatment for stage IIIC endometrial cancer

OBJECTIVE: Our purpose was to review our results of multimodality treatment of lymph node metastasis in endometrial cancer (stage IIIC). STUDY DESIGN: All patients underwent surgical staging for endometrial cance r with complete pelvic and aortic lymphadenectomy. All macroscopic nodal me tastases were resected. Patients with microscopic nodal metastasis received adjuvant teletherapy, whereas those with macroscopic nodal metastasis rece ived chemotherapy (carboplatin AUC 5 and paclitaxel 135 mg/m(2) every 3 wee ks for 6 courses) followed by teletherapy. RESULTS: Twenty-one patients had stage IIIC disease, and one had stage IVB (inguinal nodal metastasis). Sixty-four percent of tumors were poorly diffe rentiated. Fifty-five percent of patients had pelvic nodal metastasis only and 41% had macroscopic nodal metastasis. At a median follow-up of 3.8 year s, 32% of patients had recurrence, all extrapelvic. Overall mean survival w as 48 months and progression-free survival was 40 months. Overall survival for microscopic nodal metastasis was >60 months versus 35 months for macros copic metastasis. Overall survival for pelvic nodal metastasis was 53 month s versus 42 months for aortic-inguinal metastasis. There were no complicati ons from lymphadenectomy, a 22% chemotherapeutic toxicity, and a 14% radiat ion toxicity. CONCLUSION: Our surgical, chemotherapeutic, and radiation treatment protoco l for stage IIIC endometrial cancer produced minimal toxicity and good surv ival.