Abstract
The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Medical records were abstracted from EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations between the clinicopathological variables and the rates of disease recurrence were determined. Among 1,204 reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years and the median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of the initial treatment in the group of local relapse (LR) and distant/combined sites of recurrence (DCSR) was 6.6 (95% CI=4.6 to 8.6 months) and 16.9 months (95% CI=5.6 to 28.2 months), respectively (p=0.36). The 2-year survival and 3-year survival probability in the group of LR was 54.2% (95% CI=27.2 to 81.3%) and 34.7% (95% CI=9.2 to 60.2%), compared to 50.4% (95% CI=41.1 to 59.7%) and 42.1% (95%CI= 24.1 to 60.1%) for those with DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantly different in patients with local relapse when compared to those with DCSR (p=0.69). Patients with recurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSR occurred most during the first three years. The common sites of relapses were vaginal cuff, pelvis, and lungs. No significant clinicopathological predictor for survival outcomes was identified.
Highlights
Endometrial cancer is the most common female genital tract malignancy, and the fourth most common cancer in North American women, accounting for about 6% of new cancer cases and 3% of cancer deaths per year (Siegel et al, 2014)
FIGO endometrial cancer staging is based on surgical pathology which includes a hysterectomy, bilateral salpingooophorectomy and pelvic/para-aortic lymph node dissection with pelvic washings and, for poor histologic types, an omental biopsy (Cragun et al, 2005)
Patients with Grade1 and Grade 2 endometrial tumors, less than 50% myometrium invasion, and tumor of two cm or less seem to be at low risk for recurrence and may not require a surgical lymphadenectomy.(Burker et al, 2014) Management and adjuvant treatment after surgery depends upon a patient’s risk factors for recurrence
Summary
Endometrial cancer is the most common female genital tract malignancy, and the fourth most common cancer in North American women, accounting for about 6% of new cancer cases and 3% of cancer deaths per year (Siegel et al, 2014). The five year survival rate was 95%, 68%, or 17%, if the cancer was diagnosed at a local, regional, or distant stage, respectively (Siegel et al, 2014). This study was aimed to review the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer. The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed.
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