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. 2014 Oct;8(4):1800-1806.
doi: 10.3892/ol.2014.2362. Epub 2014 Jul 18.

Natural history of recurrences in endometrial carcinoma

Bengt Sorbe  1 , Christian Juresta  2 , Cecilia Ahlin  1
Affiliations

Natural history of recurrences in endometrial carcinoma

Bengt Sorbe et al. Oncol Lett. 2014 Oct.

Abstract

The aim of the present study was to evaluate the natural history of endometrial cancer recurrences with regard to predictive and prognostic factors. Between 1990 and 1999, 100 patients were treated for recurrences of endometrial carcinoma (all FIGO stages). Overall, 90 tumors were of endometrioid type. A total of 82 patients were treated with surgery, 41 patients received adjuvant external irradiation and 91 patients received vaginal brachytherapy. The median time to recurrence (TTR) was 32 months. The recurrences were treated using a combination of high-dose-rate brachytherapy and external pelvic irradiation in 35 cases. In addition, 44 patients were treated with chemotherapy and 21 patients received other types of therapy. The complete remission rate was 29% and the overall response rate was 44%. Among patients treated with radiotherapy, the response rate was 88% and, for those treated with chemotherapy, the rate was 33%. The local control of vaginal recurrences treated with combined radiotherapy was 93%. In 45 patients (45%) a second recurrence was identified and a third recurrence occurred in 12 patients. The overall five-year survival rate was 44%. Age, FIGO grade, nuclear grade, TTR and response to treatment were found to be independent and significant prognostic factors for overall survival rate. Locoregional recurrences were associated with a generalized extra-pelvic disease in 63% of the cases.

Keywords: chemotherapy; endometrial carcinoma; natural history; radiotherapy; recurrences.

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Figures

Figure 1
Figure 1
Comparison of overall survival rate with response to treatment. Overall survival rate was significantly higher in the patient group achieving CR compared with those not achieving CR (P=0.0019). No significant difference was identified between the PR and SD groups. Patients with PD exhibited a poorer prognosis. CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.
Figure 2
Figure 2
Comparison of overall survival rate with main treatment type (radiotherapy, chemotherapy or other therapy). Patients not treated with radiotherapy or chemotherapy (surgery alone, hormones alone or no active treatment) exhibited a decreased overall survival rate compared with that of patients in the remaining two groups (P=0.047).
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