TY - JOUR
T1 - Patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial cancer
AU - Long, Kara C.
AU - Zhou, Qin
AU - Hensley, Martee L.
AU - Alektiar, Kaled M.
AU - Gomez, Jacob
AU - Gardner, Ginger J.
AU - Chi, Dennis S.
AU - Barakat, Richard R.
AU - Abu-Rustum, Nadeem R.
PY - 2012/4
Y1 - 2012/4
N2 - Objectives: To evaluate patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial adenocarcinoma. Methods: A prospectively maintained endometrial cancer database was utilized to identify all patients with stage IC endometrioid endometrial adenocarcinoma treated between 2/93 and 6/09. Patterns of recurrence and risk factors were analyzed. Results: One hundred thirty-four patients with stage IC endometrial cancer were identified. Median age was 66 years (range, 31-91 years). All patients were initially treated surgically, and 79% underwent comprehensive surgical staging with lymphadenectomy. Median number of lymph nodes removed was 18 (range, 1-45). Fifty-one patients (38%) had FIGO grade 1 tumors, 55 (41%) had grade 2 tumors, and 28 (21%) had grade 3 tumors. The majority of patients (91%) received adjuvant radiation therapy. With a median follow-up of 36 months (range, 0.6-141.4 months), 10 patients recurred. Of these, 2 (20%) were grade 1, 2 (20%) were grade 2, and 6 (60%) were grade 3. Nine (90%) of these recurrences had a distant component and 7 (70%) were fatal. Overall, the 3 year cumulative incidence failure rate for grade 1/2 tumors was 5.4%; for grade 3 tumors it was 28.9% (P < 0.001). Age, BMI, and lymphovascular invasion were not associated with an increased risk of recurrence. Conclusions: Patients with stage IC, grade 3 endometrial cancer had a significantly increased risk of recurrence (28.9%). All of these recurrences had a distant component and the majority were fatal. Further investigation into the addition of adjuvant systemic therapy in these high-risk patients is warranted.
AB - Objectives: To evaluate patterns of recurrence in 1988 FIGO stage IC endometrioid endometrial adenocarcinoma. Methods: A prospectively maintained endometrial cancer database was utilized to identify all patients with stage IC endometrioid endometrial adenocarcinoma treated between 2/93 and 6/09. Patterns of recurrence and risk factors were analyzed. Results: One hundred thirty-four patients with stage IC endometrial cancer were identified. Median age was 66 years (range, 31-91 years). All patients were initially treated surgically, and 79% underwent comprehensive surgical staging with lymphadenectomy. Median number of lymph nodes removed was 18 (range, 1-45). Fifty-one patients (38%) had FIGO grade 1 tumors, 55 (41%) had grade 2 tumors, and 28 (21%) had grade 3 tumors. The majority of patients (91%) received adjuvant radiation therapy. With a median follow-up of 36 months (range, 0.6-141.4 months), 10 patients recurred. Of these, 2 (20%) were grade 1, 2 (20%) were grade 2, and 6 (60%) were grade 3. Nine (90%) of these recurrences had a distant component and 7 (70%) were fatal. Overall, the 3 year cumulative incidence failure rate for grade 1/2 tumors was 5.4%; for grade 3 tumors it was 28.9% (P < 0.001). Age, BMI, and lymphovascular invasion were not associated with an increased risk of recurrence. Conclusions: Patients with stage IC, grade 3 endometrial cancer had a significantly increased risk of recurrence (28.9%). All of these recurrences had a distant component and the majority were fatal. Further investigation into the addition of adjuvant systemic therapy in these high-risk patients is warranted.
KW - 1988 FIGO stage IC endometrioid endometrial adenocarcinoma
KW - Patterns of recurrence
KW - Recurrence
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U2 - 10.1016/j.ygyno.2011.11.020
DO - 10.1016/j.ygyno.2011.11.020
M3 - Article
C2 - 22112609
AN - SCOPUS:84858339795
SN - 0090-8258
VL - 125
SP - 99
EP - 102
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -