Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone.
- Author:
Nazli TOPFEDAISI OZKAN
1
;
Mehmet Mutlu MEYDANLI
;
Mustafa Erkan SARI
;
Fuat DEMIRKIRAN
;
Ilker KAHRAMANOGLU
;
Tugan BESE
;
Macit ARVAS
;
Hanifi ŞAHIN
;
Ali HABERAL
;
Husnu CELIK
;
Gonca COBAN
;
Tufan OGE
;
Omer Tarik YALCIN
;
Özgür AKBAYIR
;
Baki ERDEM
;
Ceyhun NUMANOĞLU
;
Nejat ÖZGÜL
;
Gökhan BOYRAZ
;
Mehmet Coşkun SALMAN
;
Kunter YÜCE
;
Murat DEDE
;
Mufit Cemal YENEN
;
Salih TAŞKIN
;
Duygu ALTIN
;
Uğur Fırat ORTAÇ
;
Hülya AYDIN AYIK
;
Tayup ŞIMŞEK
;
Tayfun GÜNGÖR
;
Kemal GÜNGÖRDÜK
;
Muzaffer SANCI
;
Ali AYHAN
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Endometrial Neoplasms; Recurrence; Local Neoplasm Recurrence; Survival Analysis
- MeSH: Cohort Studies; Endometrial Neoplasms*; Female; Humans; Multivariate Analysis; Neoplasm Recurrence, Local; Recurrence*; Retrospective Studies; Survival Analysis; Turkey
- From:Journal of Gynecologic Oncology 2017;28(5):e65-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone. METHODS: A multicenter, retrospective department database review was performed to identify patients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected. RESULTS: We identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5–34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7–105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR ≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65–43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69–12.58; p=0.003) were significant predictors. CONCLUSION: Low-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.
