The choice of adjuvant treatment of endometrial cancer III A-C stages

Dyakiv I.B.1, Kryzhanivska A.E. 1, Ryzhyk V.M.1, Sokolovska M.V.2, Vivcharenko Yu.K.3

Summary. The aim of the study. To evaluate adjuvant treatment in patients with stage IIIA–C of endometrial cancer. Material and methods. A retrospective study was conducted of 44 patients with advanced endometrial cancer, stages IIIA–C, who received complex treatment at the Carpathian Clinical Oncology Center of the Ivano-Frankivsk Regional Council from 2020 to 2022. The age of the patients is from 41 to 83 years, on average — 63.5±7.8 years. Staging of endometrial cancer was performed according to the FIGO classification (2021): IIIA — 9 (20.5%), IIIB — 8 (18.1%), IIIC — 27 (61.4%). Morphological verification was performed for all patients — endometrial adenocarcinoma of various degrees of differentiation was confirmed in 26 (59.0%) patients, as well as other histological variants: mucinous, serous, clear cell adenocarcinoma, and squamous cell carcinoma was detected in 18 (41.0%). Results. All patients with endometrial cancer underwent surgical treatment. Type II panhysterectomy with omentectomy was performed in 33 (75.0%) patients with endometrial cancer. Panhysterectomy of type I and panhysterectomy of type III + omentum resection were performed in 8 (18.2%) and 3 (6.8%), respectively. Nowadays, there is no single consensus in the standards of treatment women with stage IIIA–C endometrial cancer according to FIGO. A combination of surgical treatment with chemotherapy and/or radiotherapy is used. 36 (81.8%) patients received adjuvant treatment with chemotherapy (paclitaxel/carboplatin). 2 (4.5%) patients received a postoperative course of radiation therapy, RD 2 Gy to SOD 40 Gy. 6 (13.7%) patients received postoperative treatment with radiation and chemotherapy. Conclusions. Improving the complex treatment of patients with endometrial cancer, which combines surgery, radiation therapy and chemotherapy. One of the ways to improve the effectiveness of complex treatment according to modern literature and research is radiomodification of radiation therapy and improvement of the methods of using chemotherapy drugs.

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