Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 18;13(6):1367.
doi: 10.3390/cancers13061367.

Salvage Radiation for Pelvic Relapse after Surgically Treated Endometrial Cancer

Kristina Lindemann  1   2 , Elisabeth Smogeli  2 , Milada Cvancarova Småstuen  3 , Kjersti Bruheim  4 , Jone Trovik  5   6 , Terje Nordberg  7 , Gunnar B Kristensen  8 , Henrica M J Werner  9 , Esten Nakken  4
Affiliations

Salvage Radiation for Pelvic Relapse after Surgically Treated Endometrial Cancer

Kristina Lindemann et al. Cancers (Basel). .

Abstract

(1) Background: This study evaluated the clinical outcome after salvage radiotherapy for first pelvic relapse after endometrial cancer (EC). (2) Methods: This multicenter retrospective study included EC patients with first central pelvic relapse without lymph node involvement treated with curative intent. Progression-free (PFS) and overall survival (OS) were calculated with the Kaplan-Meier method and possible predictive factors for risk of relapse and mortality were identified using the Cox model. (3) Results: We included 139 patients with median EQD2 (Equivalent Dose in 2 Gy fractions) to the clinical target volume of 70.0 Gy. During follow up of median 6.66 years, 39.6% patients developed a second relapse. Risk group classification at primary diagnosis based on histology, grading and FIGO stage and how the pelvic tumor boost was administered were independently associated with PFS and OS. Five-year OS was 68% (95% CI (59-75)) for the whole cohort. Five-year OS was 88% (95% CI (75-94)), 72% (95% CI (55-84)) and 38% (95% CI (15-60)) for the stage I low-, intermediate- and high-risk group, respectively. (4) Conclusions: The majority of central pelvic recurrences in RT-naive EC women can be successfully salvaged with radiotherapy. However, survival in patients with high-risk disease remains poor and warrants a more individualized approach to optimize outcome.

Keywords: endometrial cancer; outcome; pelvic relapse; salvage radiation; vaginal relapse.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Composite progression-free survival by risk group at primary diagnosis.
Figure 2
Figure 2
Composite progression-free survival by type of boost administration.
Figure 3
Figure 3
Cumulative overall mortality by causes of death.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ferlay J., Colombet M., Soerjomataram I., Mathers C., Parkin D.M., Pineros M., Znaor A., Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int. J. Cancer. J. Int. Du Cancer. 2019;144:1941–1953. doi: 10.1002/ijc.31937. - DOI - PubMed
    1. Colombo N., Creutzberg C., Amant F., Bosse T., Gonzalez-Martin A., Ledermann J., Marth C., Nout R., Querleu D., Mirza M.R., et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, treatment and follow-up. Ann. Oncol. Off. J. Eur. Soc. Med Oncol. Esmo. 2016;27:16–41. doi: 10.1093/annonc/mdv484. - DOI - PMC - PubMed
    1. Jeppesen M.M., Jensen P.T., Gilsa Hansen D., Iachina M., Mogensen O. The nature of early-stage endometrial cancer recurrence-A national cohort study. Eur J Cancer. 2016;69:51–60. doi: 10.1016/j.ejca.2016.09.033. - DOI - PubMed
    1. Smogeli E., Davidson B., Cvancarova M., Holth A., Katz B., Risberg B., Kristensen G., Lindemann K. L1CAM as a prognostic marker in stage I endometrial cancer: A validation study. BMC Cancer. 2016;16:596. doi: 10.1186/s12885-016-2631-4. - DOI - PMC - PubMed
    1. Creutzberg C.L., van Putten W.L., Koper P.C., Lybeert M.L., Jobsen J.J., Warlam-Rodenhuis C.C., De Winter K.A., Lutgens L.C., van den Bergh A.C., van de Steen-Banasik E., et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: Multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet. 2000;355:1404–1411. doi: 10.1016/S0140-6736(00)02139-5. - DOI - PubMed

LinkOut - more resources