The Effect of Primary Surgical Technique for

Treatment of Endometrial Cancer and Timing of

Adjuvant Radiation Therapy

Melissa Schwartz; Shannon Tomita; Valentin Kolev; Samantha Raymond; Jessica Overbey; Vishal Gupta; Stephanie V Blank; Manjeet Chadha

Research Article

The Effect of Primary Surgical Technique for Treatment of Endometrial Cancer and Timing of Adjuvant Radiation Therapy

Melissa Schwartz¹, Shannon Tomita¹*, Valentin Kolev¹, Samantha Raymond², Jessica Overbey2, Vishal Gupta³, Stephanie V Blank¹ and Manjeet Chadha³

¹Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Icahn School of Medicine at Mount Sinai, New York, USA

²Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA

³Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA

Corresponding Author

Received Date: October 18, 2019 Published Date: November 05, 2019

Abstract

Objective: To determine if surgical approach (open, laparoscopic, robotic) influences time to initiation of adjuvant radiation therapy in women with endometrial cancer.

Methods: The National Cancer Database was used to search for patients with stage I to III endometrial cancer who received adjuvant radiation therapy from 2010-2012. Demographic, socioeconomic and clinical information was abstracted for each patient. Time to initiation of adjuvant radiation therapy was compared between groups using univariable (unadjusted) and multivariable (adjusted for all demographic and clinical variables) Cox regression models.

Results: A total of 15,480 patients were included in our study. 47.9% of patients underwent laparotomy or an unspecified surgical approach, 38.6% underwent robotic surgery, and 13.5% had a laparoscopic surgery. The distribution of time to radiation was significantly different among these groups with hazards ratios 1.0 (reference), 1.1 [95% CI 1.07, 1.15] and 1.15 [95% CI 1.02-1.06] for open, robotic and laparoscopic surgery (p<0.0001), respectively. After adjusting for covariates, younger age and worse disease status as measured by stage and grade are associated with longer wait times to radiation.

Conclusions: Women who underwent open staging surgery for endometrial cancer experienced delays from surgery to initiation of adjuvant radiation therapy as compared to women who had minimally invasive surgery.

Article Details

Citation

Shannon Tomita, Melissa Schwartz, Valentin Kolev, Samantha Raymond, Jessica Overbey, et al. The Effect of Primary Surgical Technique for Treatment of Endometrial Cancer and Timing of Adjuvant Radiation Therapy. W J Gynecol Women’s Health. 3(1): 2019. WJGWH. MS.ID.000553.