DOI QR코드

DOI QR Code

Relapse Patterns and Outcomes Following Recurrence of Endometrial Cancer in Northern Thai Women

  • Kaewpangchan, Phakdee (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University) ;
  • Cheewakriangkrai, Chalong (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
  • Published : 2015.05.18

Abstract

Background: The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Materials and Methods: Medical records were abstracted from EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations between the clinicopathological variables and the rates of disease recurrence were determined. Results: Among 1,204 reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years and the median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of the initial treatment in the group of local relapse (LR) and distant/combined sites of recurrence (DCSR) was 6.6 (95% CI=4.6 to 8.6 months) and 16.9 months (95% CI=5.6 to 28.2 months), respectively (p=0.36). The 2-year survival and 3-year survival probability in the group of LR was 54.2% (95% CI=27.2 to 81.3%) and 34.7% (95% CI=9.2 to 60.2%), compared to 50.4% (95% CI=41.1 to 59.7%) and 42.1% (95%CI= 24.1 to 60.1%) for those with DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantly different in patients with local relapse when compared to those with DCSR (p=0.69). Conclusions: Patients with recurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSR occurred most during the first three years. The common sites of relapses were vaginal cuff, pelvis, and lungs. No significant clinicopathological predictor for survival outcomes was identified.

Keywords

Endometrial cancer;recurrence;relapse;Northern Thailand

References

  1. Agboola OO, Grunfeld E, Coyle D, Perry GA (1997). Costs and benefits of routine follow-up after curative treatment for endometrial cancer. CMAJ, 157, 879-86.
  2. Berchuck A, Anspach C, Evans AC, et al (1995). Postsurgical surveillance of patients with FIGO stage I/II endometrial adenocarcinoma. Gynecol Oncol, 59, 20-4. https://doi.org/10.1006/gyno.1995.1262
  3. Burke WM, Orr J, Leitao M, et al (2014). Endometrial cancer: a review and current management strategies: part II. Gynecol Oncol, 134, 393-402. https://doi.org/10.1016/j.ygyno.2014.06.003
  4. Burke WM, Orr J, Leitao M, et al (2014). Endometrial cancer: a review and current management strategies: part I. Gynecol, 134, 385-92.
  5. Cragun JM, Havrilesky LJ, Calingaert B, et al (2005). Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol, 23, 3668-75. https://doi.org/10.1200/JCO.2005.04.144
  6. Demiral S, Beyzadeoglu M, Sager O, et al (2014). Evaluation of treatment outcomes of early-stage endometrial cancer radiotherapy: a single center experience. Asian Pac J Cancer Prev, 15, 9599-602. https://doi.org/10.7314/APJCP.2014.15.22.9599
  7. Hidaka T, Nakamura T, Shima T, Yuki H, Saito S (2006). Paclitaxel/carboplatin versus cyclophosphamide/adriamycin/cisplatin as postoperative adjuvant chemotherapy for advanced endometrial adenocarcinoma. J Obstet Gynaecol Res, 32, 330-7. https://doi.org/10.1111/j.1447-0756.2006.00405.x
  8. Huang HJ, Tang YH, Chou HH, et al (2014). Treatment failure in endometrial carcinoma. Int J Gynecol Cancer, 24, 885-93. https://doi.org/10.1097/IGC.0000000000000131
  9. Jamison PM, Noone AM, Ries LA, Lee NC, Edwards BK (2013). Trends in endometrial cancer incidence by race and histology with a correction for the prevalence of hysterectomy, SEER 1992 to 2008. Cancer Epidemiol Biomarkers Prev, 22, 233-41. https://doi.org/10.1158/1055-9965.EPI-12-0996
  10. Krusun S, Pesee M, Rasio W, et al (2014). Survival rate of early stage endometrioid adenocarcinoma of endometrium treated at Srinagarind Hospital. Asian Pac J Cancer Prev, 15, 2217-20. https://doi.org/10.7314/APJCP.2014.15.5.2217
  11. Morrow CP, Bundy BN, Kurman RJ, et al (1991). Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol, 40, 55-65. https://doi.org/10.1016/0090-8258(91)90086-K
  12. Panggid KC, Cheewakriangkrai C, Khunamornpong S, Siriaunkgul S (2010). Factors related to recurrence in non-obese women with endometrial endometrioid adenocarcinoma. J Obstet Gynaecol Res, 36, 1044-8. https://doi.org/10.1111/j.1447-0756.2010.01289.x
  13. Podczaski E, Kaminski P, Gurski K, et al (1992). Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery. Gynecol Oncol, 47, 323-7. https://doi.org/10.1016/0090-8258(92)90134-5
  14. Setakornnukul J, Petsuksiri J, Wanglikitkoon S, et al (2014). Long term outcomes of patients with endometrial carcinoma treated with radiation - Siriraj Hospital experience. Asian Pac J Cancer Prev, 15, 2279-85. https://doi.org/10.7314/APJCP.2014.15.5.2279
  15. Siegel RJ, Ma J, Zou Z, Jemal A (2014). Cancer statistics, 2014. CA Cancer J Clin, 64, 9-29. https://doi.org/10.3322/caac.21208
  16. Sohaib SA, Houghton SL, Meroni R, et al (2007). Recurrent endometrial cancer: patterns of recurrent disease and assessment of prognosis. Clin Radiol, 62, 28-34. https://doi.org/10.1016/j.crad.2006.06.015
  17. Sovak MA, Hensley ML, Dupont J, et al (2006). Paclitaxel and carboplatin in the adjuvant treatment of patients with high-risk stage III and IV endometrial cancer: a retrospective study. Gynecol Oncol, 103, 451-7. https://doi.org/10.1016/j.ygyno.2006.03.019

Cited by

  1. Can Cancer Therapy be Achieved by Bridging Apoptosis and Autophagy: a Method Based on microRNA-Dependent Gene Therapy and Phytochemical Targets vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7435
  2. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer vol.96, pp.51, 2017, https://doi.org/10.1097/MD.0000000000009223