{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:06:41Z","timestamp":1775070401836,"version":"3.50.1"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n            <jats:title>Purpose:<\/jats:title>\n            <jats:p>Radiation therapy (RT) for stages I-II uterine papillary serous carcinoma (UPSC), clear cell (CC), and high-grade endometrioid (HGE) carcinoma present a treatment challenge. Regimens include external beam radiotherapy (EBRT) with or without brachytherapy. We examine the use of these radiation modalities in these endometrial cancers (EC) with respect to cause-specific survival (CSS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with AJCC stages I-II UPSC, CC, or HGE cancer treated with hysterectomy and RT between 1998 and 2008. Patients who did not receive adjuvant RT or received brachytherapy alone were excluded. CSS was evaluated by the Kaplan-Meier survival analysis and the log-rank test was used to compare CSS. Multivariate analysis was performed using the Cox proportional hazards regression model. Adjusted hazard ratios (HR) were calculated for risk of EC death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>There were 1653 patients included in this analysis. The overall 100-month CSS for the entire cohort was 81.0%. The 100-month CSS was 85.3% for EBRT alone and 86.5% for EBRT+brachytherapy (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.72). Stage IC\/IIA\/IIB patients had a greater risk of EC death compared with stage IA\/IB patients (adjusted HR=2.39; <jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.0001). Patients with UPSC and CC had a slightly higher risk of EC death compared with HGE (adjusted HR=1.01 [<jats:italic toggle=\"yes\">P<\/jats:italic>=0.97] and 1.42 [<jats:italic toggle=\"yes\">P<\/jats:italic>=0.02], respectively). On subset analysis, there was no difference in CSS with the addition of brachytherapy for UPSC (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.37), CC (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.27), or HGE cancer patients (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.42). Patients treated with brachytherapy in addition to EBRT did not demonstrate a reduced adjusted risk of EC death compared with EBRT alone (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.38).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The addition of brachytherapy to adjuvant EBRT in stages I-II UPSC, CC, and HGE cancer did not demonstrate superior CSS. Thus, patients may not benefit from the addition of brachytherapy to EBRT.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/coc.0000000000000065","type":"journal-article","created":{"date-parts":[[2016,3,29]],"date-time":"2016-03-29T15:07:46Z","timestamp":1459264066000},"page":"335-339","source":"Crossref","is-referenced-by-count":14,"title":["Adjuvant Pelvic Radiation Therapy\u00b1Vaginal Brachytherapy in Patients With High-risk Stage I or Stage II Uterine Papillary Serous, Clear Cell, and High-grade Endometrioid Carcinoma"],"prefix":"10.1097","volume":"39","author":[{"given":"Himanshu","family":"Nagar","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weisi","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhupesh","family":"Parashar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dattatreyudu","family":"Nori","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.S.C.","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Christos","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecological Oncology, New York-Presbyterian\/Weill Cornell Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Holcomb","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecological Oncology, New York-Presbyterian\/Weill Cornell Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecological Oncology, New York-Presbyterian\/Weill Cornell Medical College"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Gabriella","family":"Wernicke","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230905","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/GRF.0b013e318218c755","article-title":"Uterine papillary serous carcinoma","volume":"54","author":"Moore","year":"2011","journal-title":"Clin Obstet Gynecol"},{"key":"R2-20230905","first-page":"419","article-title":"Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients","volume":"56","author":"Aalders","year":"1980","journal-title":"Obstet Gynecol"},{"key":"R3-20230905","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/S0140-6736(00)02139-5","article-title":"Surgery and postoperative radiotherapy versus surgery alone for patients with stage I endometrial carcinoma: Multicentre randomized trial: PORTEC Study Group: post operative radiation therapy in endometrial carcinoma","volume":"355","author":"Creutzberg","year":"2000","journal-title":"Lancet"},{"key":"R4-20230905","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.ygyno.2003.11.048","article-title":"A phase III trial of surgery with or without adjuvant external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncologic Group study","volume":"92","author":"Keys","year":"2004","journal-title":"Gynecol Oncol"},{"key":"R5-20230905","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/S0140-6736(09)62163-2","article-title":"Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial","volume":"375","author":"Nout","year":"2010","journal-title":"Lancet"},{"key":"R6-20230905","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.ygyno.2009.06.011","article-title":"Management of women with uterine papillary serous cancer: a society of Gynecologic Oncology (SGO) review","volume":"115","author":"Boruta","year":"2009","journal-title":"Gynecol Oncol"},{"key":"R7-20230905","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/djs374","article-title":"Adjuvant radiotherapy for stage I endometrial cancer: an updated Cochrane systematic review and meta-analysis","volume":"104","author":"Kong","year":"2012","journal-title":"J Natl Cancer Inst"},{"key":"R8-20230905","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1093\/jnci\/djs434","article-title":"The role of adjuvant radiation therapy for stage I endometrial cancer: does meta-analysis reveal the answer","volume":"104","author":"Eifel","year":"2012","journal-title":"J Natl Cancer Inst"},{"issue":"suppl","key":"R9-20230905","doi-asserted-by":"crossref","first-page":"abstr 5008","DOI":"10.1200\/jco.2012.30.15_suppl.5008","article-title":"Survival after radiation therapy for early-stage endometrial carcinoma: the Oslo study revisited after up to 43 years of follow-up","volume":"30","author":"Lindemann","year":"2012","journal-title":"J Clin Oncol"},{"key":"R10-20230905","doi-asserted-by":"crossref","first-page":"e639","DOI":"10.1016\/j.ijrobp.2011.01.053","article-title":"Impact of adjuvant external-beam radiation therapy in early-stage uterine papillary serous and clear cell carcinoma","volume":"81","author":"Kim","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R11-20230905","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/IGC.0b013e3182643ba0","article-title":"External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium-risk endometrial carcinoma: a prospective, randomized study\u2014quality-of-life analysis","volume":"22","author":"Sorbe","year":"2012","journal-title":"Int J Gynecol Cancer"},{"key":"R12-20230905","first-page":"35","article-title":"Postoperative intravaginal radiation therapy as an adjunct to external irradiation in high risk endometrial adenocarcinoma: An evaluation of two different dose schedules","volume":"7","author":"Reisinger","year":"1991","journal-title":"Endocuriether\/Hyperthermia Oncol"},{"key":"R13-20230905","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1006\/gyno.1998.4956","article-title":"Uterine papillary serous carcinoma: evaluation of long-term survival in surgically staged patients","volume":"69","author":"Grice","year":"1998","journal-title":"Gynecol Oncol"},{"key":"R14-20230905","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0090-8258(03)00195-1","article-title":"Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium","volume":"90","author":"Chan","year":"2003","journal-title":"Gynecol Oncol"},{"key":"R15-20230905","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1006\/gyno.2001.6159","article-title":"Extended surgical staging for uterine papillary serous carcinoma: survival outcomes of locoregional disease (stage I\u2013III) disease","volume":"81","author":"Bristow","year":"2001","journal-title":"Gynecol Oncol"},{"key":"R16-20230905","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ygyno.2007.05.044","article-title":"Role of systematic lymphadenectomy and adjuvant therapy in stage I uterine papillary serous carcinoma","volume":"107","author":"Thomas","year":"2007","journal-title":"Gynecol Oncol"},{"key":"R17-20230905","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.ygyno.2003.08.018","article-title":"Uterine papillary serous carcinoma: a single institution review of 129 cases","volume":"91","author":"Slomovitz","year":"2003","journal-title":"Gynecol Oncol"},{"key":"R18-20230905","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.ijrobp.2005.03.028","article-title":"Impact of adjuvant therapy on survival with early stage papillary serous carcinoma","volume":"63","author":"Hamilton","year":"2005","journal-title":"Int J Radiol Oncol Biol Phys"},{"key":"R19-20230905","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/cncr.26295","article-title":"Underascertainment of radiotherapy receipt in Surveillance, Epidemiology, and End Results registry data","volume":"118","author":"Jagsi","year":"2012","journal-title":"Cancer"}],"container-title":["American Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00000421-201608000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T23:37:01Z","timestamp":1693957021000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000421-201608000-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/coc.0000000000000065","relation":{},"ISSN":["0277-3732"],"issn-type":[{"value":"0277-3732","type":"print"}],"subject":[],"published":{"date-parts":[[2016,8]]}}}