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Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone.
- Source :
-
Journal of gynecologic oncology [J Gynecol Oncol] 2017 Sep; Vol. 28 (5), pp. e65. Date of Electronic Publication: 2017 Jun 16. - Publication Year :
- 2017
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Abstract
- Objective: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone.<br />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.<br />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.<br />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.<br />Competing Interests: No potential conflict of interest relevant to this article was reported.<br /> (Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology)
- Subjects :
- Aged
Carcinoma, Endometrioid mortality
Carcinoma, Endometrioid pathology
Carcinoma, Endometrioid surgery
Endometrial Neoplasms pathology
Female
Humans
Hysterectomy
Lymph Node Excision
Middle Aged
Myometrium
Proportional Hazards Models
Retrospective Studies
Risk Factors
Salpingo-oophorectomy
Time Factors
Turkey
Endometrial Neoplasms mortality
Endometrial Neoplasms surgery
Neoplasm Recurrence, Local mortality
Subjects
Details
- Language :
- English
- ISSN :
- 2005-0399
- Volume :
- 28
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 28657226
- Full Text :
- https://doi.org/10.3802/jgo.2017.28.e65