Prognostic factors and treatment outcome for patients with locally recurrent endometrial cancer

• Published in: Cancer Vol. 74; no. 4; pp. 1303 - 1308
• Main Authors: Sears, Judith D., Greven, Kathryn M., Hoen, Helena M., Randall, Marcus E.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 15.08.1994; Wiley-Liss
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - radiotherapy; Adenocarcinoma - surgery; Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; Cobalt Radioisotopes - adverse effects; Cobalt Radioisotopes - therapeutic use; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - radiotherapy; Neoplasm Staging; Pelvic Neoplasms - pathology; Pelvic Neoplasms - radiotherapy; Prognosis; radiation therapy; Radiotherapy, High-Energy - adverse effects; recurrent endometrial carcinoma; Retrospective Studies; Risk Factors; Salvage Therapy; Survival Rate; Treatment Outcome; Tumors; uterine neoplasms; vaginal neoplasms; Vaginal Neoplasms - pathology; Vaginal Neoplasms - radiotherapy; Human; Relapse; Carcinoma; Prognosis; Treatment; Surgery; Uterine diseases; Female; Malignant tumor; Endometrium; Female genital diseases
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19940815)74:4<1303::AID-CNCR2820740420>3.0.CO;2-G

Background. Women who do not receive adjuvant irradiation after hysterectomy for endometrial carcinoma (EC) are at risk for developing a pelvic recurrence. Disease‐ and treatment‐related factors were examined for their impact on disease‐specific survival (DSS) and pelvic control (PC) in patients with locoregional recurrences to whom salvage radiotherapy was administered. Methods. Forty‐five patients with pelvic/vaginal recurrences of EC were treated at a single institution between 1973 and 1991. The median follow‐up period was 89 months. Multiple patient‐, disease‐, and treatment‐related factors were examined with univariate and multi‐variate analysis for their impact on DSS and PC. Kaplan‐Meier methods were used to estimate outcomes. Results. Overall DSS and PC was 51 and 54% at 5 years, respectively. Univariate analysis revealed the following factors to impact on outcome (Peg 0.05): age (DSS, PC), vaginal stage of recurrence (DSS, PC), size of recurrence (DSS, PC), time interval from hysterectomy (DSS, PC), initial grade (DSS), location of recurrence (PC), and radiation boost technique (PC). Conclusion. Women in whom endometrial cancer recurrences develop can be salvaged with aggressive radiotherapy consisting of external beam therapy followed by a radiation boost. Close follow‐up after the initial hysterectomy is important because patients with low‐volume recurrence limited to the vagina have the best outcome.