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. 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.

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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

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