Surgery With or Without Lymphadenectomy and Radiation Therapy in Treating Patients With Endometrial Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00003749
Recruitment Status : Completed
First Posted : January 27, 2003
Last Update Posted : December 19, 2013
Information provided by:
National Cancer Institute (NCI)

November 1, 1999
January 27, 2003
December 19, 2013
April 1998
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Complete list of historical versions of study NCT00003749 on Archive Site
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Surgery With or Without Lymphadenectomy and Radiation Therapy in Treating Patients With Endometrial Cancer
A Randomised Trial of Lymphadenectomy and of Adjuvant External Beam Radiotherapy in the Treatment of Endometrial Cancer

RATIONALE: Lymphadenectomy may remove cancer cells that have spread to nearby lymph nodes. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known whether conventional surgery is more effective with or without lymphadenectomy and/or radiation therapy in treating endometrial cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of conventional surgery with or without lymphadenectomy and/or radiation therapy in treating patients who have endometrial cancer.


  • Compare the effects of conventional surgery alone and conventional surgery plus lymphadenectomy in patients with endometrial cancer preoperatively thought to be confined to the uterine corpus.
  • Determine the effect of postoperative adjuvant external beam radiotherapy on quality of life and survival of a subset of these patients at high risk of relapse and with no macroscopic disease after surgery.

OUTLINE: This is a randomized, multicenter study. Patients are randomized in both the surgery and radiotherapy segments of the study.

  • Surgery: Patients are randomized to 1 of 2 surgery arms.

    • Arm I: Patients undergo conventional surgery (total abdominal hysterectomy and bilateral salpingo-oophorectomy).
    • Arm II: Patients undergo conventional surgery as in arm I followed by lymphadenectomy with systematic dissection of the iliac and obturator nodes.
  • Radiotherapy: Patients at high risk of relapse who have no postoperative macroscopic disease are randomized to 1 of 2 radiotherapy arms. (Patients may enter the radiotherapy randomization after surgery off study.)

    • Arm I: Patients receive in 20-25 fractions of external beam radiotherapy (total dose of 40-46 Gy) over 4-5 weeks.
    • Arm II: Patients receive no external beam radiotherapy. NOTE: Some patients receive vault brachytherapy regardless of radiotherapy randomization.

Quality of life is assessed before therapy and at 2 and 5 years after therapy.

Patients are followed every 3 months for 1 year and then every 6 months for 1 year.

PROJECTED ACCRUAL: A minimum of 1400 patients will be accrued for the surgical component of this study and at least 900 patients (including additional patients not participating in the surgical component of this study) will be accrued for the radiotherapy component of this study.

Phase 3
Allocation: Randomized
Primary Purpose: Treatment
Endometrial Cancer
  • Procedure: adjuvant therapy
  • Procedure: conventional surgery
  • Radiation: brachytherapy
  • Radiation: radiation therapy
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*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
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December 2008
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Surgical randomization:

  • Histologically confirmed endometrial carcinoma
  • Disease thought preoperatively to be confined to the uterine corpus

Radiotherapy randomization:

  • Must have disease determined postoperatively to be confined to the uterine corpus, irrespective of pelvic node status

    • No cervical stroma invasion (stage IIB)
  • Must be macroscopically free of disease (no positive para-aortic nodes)
  • Must have high-risk disease defined as one or more of the following:

    • Grade 3 (poorly differentiated)
    • Invasion to the outer half of the myometrium (stage IC)
    • Serous papillary or clear cell type
    • Stage IIA (endocervical glandular involvement)



  • Any age

Performance status:

  • Not specified

Life expectancy:

  • Not specified


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  • No other prior or concurrent malignancy likely to interfere with protocol treatment or comparisons
  • Surgical randomization:

    • Must be fit to undergo lymphadenectomy and external beam radiotherapy
  • Radiotherapy randomizations:

    • Must be fit to receive external beam radiotherapy


Biologic therapy:

  • Not specified


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Endocrine therapy:

  • Not specified


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  • Not specified
Sexes Eligible for Study: Female
Child, Adult, Older Adult
Contact information is only displayed when the study is recruiting subjects
United Kingdom
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Medical Research Council
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Investigator: Claire Amos Medical Research Council
National Cancer Institute (NCI)
April 1999

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP