Evaluation of the role of liver metastasectomy in the treatment of stage IV endometrial cancer
- Author:
Xavier L. BALDWIN
1
;
Jihye PARK
;
Joyce PAK
;
Leslie H. CLARK
;
Hong Jin KIM
;
Michael T. LECOMPTE
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2025;36(5):e79-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Hepatic metastasectomy for gynecologic cancers remains controversial.Management of advanced endometrial cancer (EC) is complex. The purpose of this study is to analyze the efficacy of liver metastasectomy (LM) in the treatment of metastatic EC.
Methods:The National Cancer Database was used to create a retrospective cohort of adult women with EC metastatic to the liver between 2010 and 2016. Overall survival and all-cause mortality were estimated with inverse probability of treatment weighting (IPTW) curves and IPTW Cox proportional hazard regression, respectively.
Results:Among 999 EC patients with oligometastatic disease to the liver, 162 (16.2%) underwent LM, 614 (61.5%) received chemotherapy, and 129 (12.9%) had chemotherapy and LM. Those who underwent chemotherapy, 1-, 2-, and 3-year survival for chemotherapy + LM versus chemotherapy alone were 67.8 versus 56.5%, 44.9 versus 33.4%, and 35.1 versus 23.1%, respectively. In unadjusted analysis, chemotherapy + LM group had reduced mortality risk (hazard ratio [HR]=0.68; 95% confidence interval [CI]=0.54–0.86) with longer median survival time (20.1 vs. 14.6 months, p=0.011) compared to chemotherapy alone. Adjusting for demographics and treatment characteristics, a possible reduction in mortality was associated with chemotherapy + LM (HR=0.74; 95% CI=0.55–1.01) compared to chemotherapy alone.
Conclusion:This study of LM for EC suggests LM in addition to chemotherapy may be associated with improved outcomes for patients with EC.
