GOG-258

After surgery for stage III–IVA endometrial cancer, does chemoradiotherapy improve relapse-free survival vs chemotherapy alone?

Population and treatment

736 eligible patients with surgically staged stage III–IVA endometrial carcinoma.

Intervention vs comparator: Chemotherapy plus pelvic radiotherapy vs six cycles chemotherapy alone.

Registry: https://pubmed.ncbi.nlm.nih.gov/?term=GOG-258+chemoradiotherapy+endometrial+cancer+NEJM

Results

Five-year relapse-free survival 59% with chemoradiotherapy vs 58% with chemotherapy alone (HR 0.90, 90% CI 0.74–1.10). Chemoradiotherapy reduced vaginal and pelvic/para-aortic recurrence but distant recurrence was more frequent in the chemoradiotherapy arm; OS was not improved.

Relapse-free survival · 5 years

NNT: NCT00942357

NNH not calculated without defensible fixed-time excess-harm risk. Never derive NNT from median survival or HR alone.

Toxicity and treatment burden

58

Full grade 3–5 toxicity, discontinuation, QoL and treatment exposure require primary-report/supplement extraction before full clinical signoff. Missing rates are not imputed.

Interpretation and limitations

Do not describe chemoradiotherapy as superior for RFS/OS. The trade-off is locoregional control versus distant failure and treatment burden; extract exact recurrence-site rates and toxicity from the paper.

Distinguish prespecified from exploratory subgroups, mature from immature endpoints, and superiority from non-inferiority. Verify current guidelines and eligibility.

Primary source

Primary publication / authoritative source ↗

Source-level QoL, discontinuation, full toxicity and guideline currency audit remains a QC requirement.