Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone.

Nazli TOPFEDAISI OZKAN; 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

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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

1. Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey. drerkansari@gmail.com
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.