Adjuvant treatment after surgery for endometrial cancer: Survey of practice among Thai gynecologic oncologists

Abstract

© Journal of The Medical Association of Thailand Objective: To evaluate the practice of Thai gynecologic oncologists regarding the adjuvant treatment after surgery for endometrial cancer. Materials and Methods: A web-based survey by the Thai Gynecologic Cancer Society was conducted from August to October, 2019 to assess the pattern of gynecologic cancer management of the Thai gynecologic oncologists. The respondents had to have at least 1 year of practice in this field and were currently working in the country. Data of practice on postoperative adjuvant treatment for each stage of endometrial cancer were retrieved and analyzed. Results: The mean age of all 167 gynecologic oncologists who responded to the questionnaire was 41.0+8.26 years. No adjuvant treatment was selected in 40% of stage IA and 3% of stage IB whereas all responded one or more types of adjuvant treatments for stage II and over. Pelvic radiation was most commonly used for stage I-II. Brachytherapy was the most common mode of radiation for stage IA (57.5%) and IB (88.1%) whereas external pelvic beam irradiation was more common in stage II (38.9% without and 36.5% with brachytherapy). Only 2 to 8% reported chemotherapy use for stage I-II and increased to 80 to 97% in stage III-IV. Chemotherapy was reported as the sole therapy in 20% of stage III and 70% of stage IV whereas the remaining had combined chemotherapy and radiation. Extended field radiation was used in 15 to 30% of stage IIIA to IIIC1 and 62% in stage IIIC2. Conclusion: Thai gynecologic oncologists used adjuvant therapy mainly according to the stage of endometrial cancer. The main treatment for stage I-II was radiation therapy, with chemotherapy in some patients. Chemotherapy was the major adjuvant treatment (80 to 90%) of stage III and almost all stage IV.