Higher risk of uterine cancer recurrence when radiation therapy after hysterectomy is delayed

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The risk of uterine cancer recurrence may be increased by waiting too long after a hysterectomy to begin radiation therapy. For patients with uterine cancer who are not receiving chemotherapy, tumors were found to be more likely to return if radiation therapy was delayed 9 weeks or longer following surgery. Among those who delayed radiation therapy, only 43% had relapse-free survival after 5 years. In contrast, patients who started radiation therapy soon after surgery had a 5-year relapse-free survival of 90%.

Endometrial cancers mainly arise from the tissue lining the uterus and are the most common gynecologic cancers in the United States. The National Cancer Institute estimates that endometrial cancers are diagnosed in 43,000 women and 7,950 died from the disease in 2010. A total hysterectomy is the most common treatment approach for endometrial cancers.

This research team assessed the impact of the time between hysterectomy and the start of radiation treatment on tumor recurrence through a retrospective study of 1,450 patients who underwent surgery for stage I to III uterine cancer between 1988 and 2010. Among these patients, 308 received radiation therapy without chemotherapy after hysterectomy with at least 1 year of follow-up. The patients had a median age of 65 years and a median follow-up of 6 years.

About 75% of the patients started radiation therapy less than 9 weeks after surgery. The others began treatment 9 or more weeks after surgery. Among the 308 patients in the study group, cancer returned in 43 cases. Tumor recurrence was significantly associated with a treatment delay of 9 weeks or longer.

“Our data suggests that a shorter interval of time between hysterectomy and start of radiation treatment may be beneficial for patients,” says lead author Mohamed Elshaikh, MD, senior staff physician in the Department of Radiation Oncology at Henry Ford Hospital.

This research was presented at the American Society for Radiation Oncology (ASTRO) 54th Annual Meeting in Boston.
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