Patterns of distant metastases in patients with endometrial carcinoma: A SEER population-based analysis.

Abstract

e17109 Background: Endometrial carcinoma is the most common gynecology malignancies in the worldwide. The clinical outcome of endometrial carcinoma is excellent, with disease specific survival rate over 90% in early stages. However, the prognosis of metastatic endometrial carcinoma is poor and the pattern of distant metastases has not been well characterized. In the present study, we sought to assess the incidence and prognosis of different distant metastatic sites in endometrial carcinoma. Methods: Patients who were diagnosed with endometrial carcinoma between 2010 and 2015 were identified according to the following criteria in the Surveillance, Epidemiology, and End Results (SEER) database: (1) confirmed age and older than 18 years old; (2) enrolled patients should have confirmed distant visceral metastatic status information. Kaplan-Meier analysis and log-rank tests were used to estimate the overall survival (OS) between difference groups. Data were analyzed with GraphPad Prism (version 7.01, GraphPad Software, USA), and R (version 4.3.1, R Development Core Team). Results: A total of 73328 patients with endometrial carcinoma were included. Median age of diagnosis was 62 years and 80.3% of patients were white. 92.8% of patents have received surgery. 4.2% of patients (3053/73328) suffered at least one site of distant metastases. The most common metastasis site was lung (1331/73328, 1.82%), followed by distant lymph nodes (1191/72703, 1.6%), liver (661/73328, 0.9%), bone (475/73328, 0.65%) and brain (133/73328, 0.18%). Median OS was 15 months, 4 months, 7 months, 9 months and 8 months for pure distant lymph node, brain, bone, lung and liver metastases, respectively. Furthermore, metastatic sites showed significant impact on OS in univariate analysis. Multivariate analysis with COX proportional regression model showed that distant metastatic sites were independent prognostic factors of OS. Conclusions: Lung is the most common distant metastatic site of endometrial carcinoma. Patients with pure distant lymph node metastasis exhibited the best overall survival, while patients with brain metastases had worst clinical prognosis compared with other metastatic sites.