Liver recurrence in endometrial cancer: a multi-institutional analysis of factors predictive of postrecurrence survival.

Abstract

Predictive factors for survival following liver metastasis in endometrial cancer (EC) have not been studied to date. It is expected that patients who initially presented with liver metastasis or developed liver metastasis as the subsequent metastatic site of progressive disease are likely to have poor outcomes. However, patients developing liver metastasis as the first site of recurrence may have a chance of benefiting from the salvage therapies. Therefore, we aimed to determine factors influencing postrecurrence survival in EC patients who developed liver metastasis as the first site of recurrence. Patients with EC who underwent primary surgery at three centers between 1993 and 2013 were reviewed. Liver recurrence was defined as documentation of parenchymal liver metastasis either by radiologically or biopsy, after a disease-free interval of ≥3months. Patients with liver metastasis at presentation, or liver metastasis as the subsequent metastatic site of progressive disease were excluded. Forty-six patients were identified. Median time to liver recurrence was 12months, with 91.3% of recurrences detected within 3years. Most patients (73.9%) had liver recurrence concomitant with extra-hepatic disease. Median survival after the diagnosis of liver recurrence was 9months. While in univariate analysis, time to liver recurrence (p<0.001) and presence of concomitant extra-hepatic metastasis (p=0.048) were potential predictors of survival, multivariate analysis revealed that time to liver recurrence (p<0.001) was the only independent predictor. This criterion may be used as a marker for stratifying patients into different prognostic risk groups and for selection of patients for salvage therapies.