From the Guidelines
Stage 3C2 R for endometrial carcinoma means the cancer has spread to the para-aortic lymph nodes and there is residual disease after surgery, necessitating adjuvant therapy such as chemotherapy and radiation therapy to improve outcomes. This classification is part of the FIGO staging system for endometrial cancer, where stage 3 indicates the cancer has spread beyond the uterus but is still confined to the pelvis or regional lymph nodes. The "C2" specifically indicates metastasis to the para-aortic lymph nodes with or without positive pelvic lymph nodes, which represents a more extensive lymphatic spread than 3C1 (pelvic nodes only) 1. The "R" designation means that despite surgical intervention, some cancer remains in the body.
According to the most recent guidelines, the combination of carboplatin and paclitaxel is the preferred option for adjuvant therapy in advanced-stage disease or high-risk histologies 1. The use of combined radiation therapy and chemotherapy is recommended as opposed to either alone, as it has been associated with increased overall survival and locoregional control rates 1. The 5-year survival rate for stage 3C endometrial cancer is approximately 50-60%, though outcomes vary based on tumor characteristics, residual disease volume, and response to treatment 1.
Key considerations for treatment include:
- The role of chemotherapy in improving progression-free survival and overall survival in patients with extrauterine disease 1
- The importance of radiation therapy in controlling locoregional disease 1
- The potential benefits and risks of combined modality therapy, including increased toxicity 1
- The need for close follow-up with gynecologic oncology and consideration of participation in clinical trials for novel therapeutic approaches 1.
Overall, the management of stage 3C2 R endometrial carcinoma requires a multidisciplinary approach, incorporating surgery, chemotherapy, and radiation therapy to optimize outcomes and minimize morbidity and mortality.
From the Research
Stage 3C2 R for Carcinoma (CA) of the Endometrium
- Stage 3C2 R refers to a specific classification of endometrial cancer, where the cancer has spread to the pelvic lymph nodes, but not to distant sites, and the patient has undergone surgical resection and is considered to be in a high-risk category for recurrence 2.
- The "R" in 3C2 R likely indicates that the patient has undergone surgical resection, which is a common treatment approach for endometrial cancer.
- The classification of stage 3C2 is based on the International Federation of Gynecology and Obstetrics (FIGO) staging system, which takes into account the extent of tumor spread and the presence of lymph node involvement.
Treatment Approaches
- For patients with stage 3C2 endometrial cancer, adjuvant chemotherapy with carboplatin and paclitaxel is often recommended to reduce the risk of recurrence 2, 3, 4.
- The addition of radiotherapy to chemotherapy may also be considered, although the optimal treatment approach is still being studied 5.
- In some cases, targeted therapies such as bevacizumab may be used in combination with chemotherapy to improve treatment outcomes 6.
Prognosis
- The prognosis for patients with stage 3C2 endometrial cancer is generally favorable, with a 5-year overall survival rate of around 75% 5.
- However, the prognosis can vary depending on factors such as the patient's age, overall health, and the presence of other medical conditions.
- Regular follow-up and monitoring are essential to detect any signs of recurrence or progression of the disease.