Objective:To assess factors associated with improved survival of medically inoperable endometrial carcinoma.
Methods:Patients with endometrial cancer who were not surgical candidates, underwent primary radiation therapy. Data were collected from medical records Survival estimates were calculated and compared.
Results:Twenty-nine of 39 patients who underwent primary radiation therapy were considered medically inoperable. Median follow up was 19 months (range 3-66). Overall survival (OS) was 38% (11 out of 29). Progression-free survival (PFS) was 34% (10 out of 29). The cancer-specific mortality was 14% (4 out 29). Fourteen of 18 deceased patients (78%) had no evidence of recurrent disease. A history of pulmonary embolism was associated with improved survival (Rate ratio of death 0.2; 95%CI, 0.01-0.98; p=0.046). Grade 3 tumors were associated with shorter survival, compared to combined grades 1 and 2 (Rate ratio of death 3.21; 95%CI, 1-8.76; p=0.05). The median OS in patients on aspirin or warfarin was 20 months (range 7-66), and 11 months (range 3-43) in patients who did not take aspirin or warfarin (Rate ratio of death: 0.35, 95%CI, 0.13-0.89; p=0.028).
Conclusion: Radiation therapy provides acceptable tumor control in patients with medically inoperable endometrial cancer. Aspirin or warfarin therapy may result in longer overall survival.