Recurrent early stage endometrial cancer : Patterns of recurrence and results of salvage therapy
Copyright © 2019 Elsevier Inc. All rights reserved..
OBJECTIVE: To analyze our institutional experience and oncologic outcomes for salvage treatment for the recurrence of early-stage endometrial cancer patients.
METHODS: We included women of all ages diagnosed with FIGO stage I-II, any grade endometrial cancer from 2000 to 2016 at our institutions who were treated with at least a hysterectomy. Recurrences in the pelvis and/or vagina were considered locoregional recurrences (LRR). Overall survival (OS) was assessed using Kaplan-Meier survival analysis. Univariate (UV) and multivariate (MV) Cox proportional hazards modeling was also used.
RESULTS: A total of 2691 women were analyzed. The majority had endometrioid histology (91%), stage IA disease (61%), and were grade 1 (57%). With a median follow-up of 6.1 years, the overall rate of recurrence was 7.2%, and the rate of LRR was 3.7%. Women with vaginal-only recurrences had a longer median OS after recurrence (14.0 years) compared to both pelvic (1.2 years) and distant (1.0 year) failures. For women with vaginal-only recurrences, salvage radiotherapy (RT) was the only factor associated with improved OS on MVA (HR 0.1, p = .04). For women with pelvic recurrences, salvage surgery (HR 0.3, p = .01), salvage RT (HR 0.3, p < .01), and salvage chemotherapy (HR 0.4, p = .03) were associated with improved OS.
CONCLUSIONS: Failure rates for women with early-stage endometrial cancer are low. Women with vaginal-only recurrences have improved OS compared to pelvic or distant recurrences. Salvage RT appears to be an important factor for treatment of women with vaginal-only recurrences. Aggressive multimodality treatment may be beneficial for women with pelvic recurrences.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:154 |
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| Enthalten in: |
Gynecologic oncology - 154(2019), 1 vom: 01. Juli, Seite 38-44 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Francis, Samual R [VerfasserIn] |
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| Links: |
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| Themen: |
Endometrial cancer |
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| Anmerkungen: |
Date Completed 26.08.2019 Date Revised 26.08.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ygyno.2019.04.676 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM296494399 |
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| 100 | 1 | |a Francis, Samual R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Recurrent early stage endometrial cancer |b Patterns of recurrence and results of salvage therapy |
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| 500 | |a Date Revised 26.08.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To analyze our institutional experience and oncologic outcomes for salvage treatment for the recurrence of early-stage endometrial cancer patients | ||
| 520 | |a METHODS: We included women of all ages diagnosed with FIGO stage I-II, any grade endometrial cancer from 2000 to 2016 at our institutions who were treated with at least a hysterectomy. Recurrences in the pelvis and/or vagina were considered locoregional recurrences (LRR). Overall survival (OS) was assessed using Kaplan-Meier survival analysis. Univariate (UV) and multivariate (MV) Cox proportional hazards modeling was also used | ||
| 520 | |a RESULTS: A total of 2691 women were analyzed. The majority had endometrioid histology (91%), stage IA disease (61%), and were grade 1 (57%). With a median follow-up of 6.1 years, the overall rate of recurrence was 7.2%, and the rate of LRR was 3.7%. Women with vaginal-only recurrences had a longer median OS after recurrence (14.0 years) compared to both pelvic (1.2 years) and distant (1.0 year) failures. For women with vaginal-only recurrences, salvage radiotherapy (RT) was the only factor associated with improved OS on MVA (HR 0.1, p = .04). For women with pelvic recurrences, salvage surgery (HR 0.3, p = .01), salvage RT (HR 0.3, p < .01), and salvage chemotherapy (HR 0.4, p = .03) were associated with improved OS | ||
| 520 | |a CONCLUSIONS: Failure rates for women with early-stage endometrial cancer are low. Women with vaginal-only recurrences have improved OS compared to pelvic or distant recurrences. Salvage RT appears to be an important factor for treatment of women with vaginal-only recurrences. Aggressive multimodality treatment may be beneficial for women with pelvic recurrences | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Endometrial cancer | |
| 650 | 4 | |a Radiotherapy | |
| 650 | 4 | |a Recurrence | |
| 650 | 4 | |a Salvage treatment | |
| 700 | 1 | |a Ager, Bryan J |e verfasserin |4 aut | |
| 700 | 1 | |a Do, Olivia A |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yu-Huei Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Soisson, Andrew P |e verfasserin |4 aut | |
| 700 | 1 | |a Dodson, Mark K |e verfasserin |4 aut | |
| 700 | 1 | |a Werner, Theresa L |e verfasserin |4 aut | |
| 700 | 1 | |a Sause, William T |e verfasserin |4 aut | |
| 700 | 1 | |a Grant, Jonathan D |e verfasserin |4 aut | |
| 700 | 1 | |a Gaffney, David K |e verfasserin |4 aut | |
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