Chemotherapy before surgery can be a helpful treatment for women with advanced endometrial cancer that cannot be immediately removed with surgery, according to a recent study in the International Journal of Gynecological Cancer.
The usual treatment for endometrial cancer is surgery. This normally includes removing the uterus, cervix, fallopian tubes and both ovaries. However, some patients with advanced endometrial cancer cannot have surgery right away because the cancer has spread too far, their overall health is poor, or they have other serious medical problems. In these cases, doctors may recommend neoadjuvant chemotherapy, which means using chemotherapy drugs to shrink a tumor before surgery.
Because there is limited information about this approach in low- and middle-income countries, researchers studied how well it worked—and how long patients lived—at a cancer center in India.
Overall, chemotherapy before surgery allowed more than half of the women to eventually have surgery, and nearly two-thirds of those surgeries removed most of the cancer.
The study also found that women who had surgery lived much longer than those who received only chemoradiotherapy (77% survival vs. 26%).
Read more about endometrial cancer treatment and care
The study included 41 women, with an average age of 55.6 years, who had stage III to IVB endometrial cancer. All of them were treated at the Gujarat Cancer Research Institute between 2017 and 2022. Because they were not healthy enough for immediate surgery, they first received chemotherapy.
After getting chemotherapy, 22 out of 41 patients (about 54%) were able to have surgery to remove the tumor. Of those who had surgery following chemotherapy, 14 patients (about 64%) had only a very small amount of cancer left afterward.
“Although a small sample size, favorable survival outcomes are observed,” the researchers said. “Further prospective studies are needed to validate these findings and refine patient selection.”
