ArticleJournal of gynecologic oncology2026
Postoperative radiation therapy in women with FIGO stage I clear cell and papillary serous carcinomas of the uterus: an analysis of the SEER database.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study analyzed postoperative radiation therapy outcomes in women with International Federation of Gynecology and Obstetrics stage I clear cell and papillary serous endometrial carcinomas to inform treatment decisions.
methodsSurveillance, Epidemiology, and End Results data (2000-2016) was analyzed for females with localized endometrial clear cell or papillary serous carcinoma. The Fine-Gray subdistribution hazard model with competing risks analysis evaluated the effect of age, histology, and radiation modality on the cumulative incidence of death from endometrial cancer. Gray's test compared survival outcomes between external beam radiation therapy (EBRT), combination of EBRT with brachytherapy, and brachytherapy.
resultsFour hundred forty-six patients were included. Mean diagnosis age was 67.92 years. Age was a significant covariate, with a 2% increased risk of death per additional year. Overall survival at 5 and 10 years was 80.87% and 77.94%, respectively. EBRT and brachytherapy were almost equally utilized; combination therapy was less common. At least 60.26% of patients treated with brachytherapy received systemic therapy, compared to 26.92% with EBRT and 12.82% with combination therapy. Brachytherapy showed superior survival outcomes compared to EBRT, with hazard ratios of 0.44 (95% confidence interval [CI]=0.26-0.74; p=0.002) for 5-year and 0.40 (95% CI=0.21-0.77; p=0.006) for 10-year outcomes. Cumulative incidence of death from cancer differed significantly between radiation modalities.
conclusionPatients predominantly received a single radiation modality. Brachytherapy was associated with superior survival outcomes and systemic therapy use, though patient selection factors may contribute to this finding. Increasing age was associated with a higher risk of death.
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