Author:
Alia Mousli,Mohamed Aziz Cherif,Marouen Benna,Ameni Yousfi,Semia Zaraa,Rim Abidi,Chiraz Nasr
Abstract
Background: Tailored adjuvant treatment is key to managing endometrial cancer effectively. Understanding prognostic factors of loco-regional failure and the impact of adjuvant treatment can help in treatment de-escalation without compromising survival outcomes. The aim of this study was to assess the pattern of failure in endometrial cancer patients and to determine predicting Loco-Regional Recurrence (LRR) factors. Patients and methods: Data were collected from 214 patients treated for endometrial cancer between 2005 and 2012 in Salah Azaiez Institute in Tunisia. All patients underwent upfront surgery followed by adjuvant brachytherapy with or without external beam radiation. The median follow-up period was 44 months. Univariate and multivariate analyses were performed to identify prognostic factors for LRR. Results: The 5-year overall survival rate was 78.1%, and the 5-year progression-free survival rate was 80.1%. LRR occurred in 25 patients (11.6%), with a median recurrence time of 29 months (range 4 months - 46 months). Pelvic relapse was the most common site, occurring in 10 patients. Vaginal relapses were observed in 9 patients, and retro-peritoneal relapses were observed in 6 cases. FIGO stage, tumor grade, histologic type, Lympho-Vascular Space Invasion (LVSI), and delays in adjuvant treatment were significant predictors of LRR. Conclusion: Identifying prognostic factors for LRR in endometrial cancer is crucial for optimizing adjuvant treatment strategies. Higher FIGO stages and the presence of LVSI were independent predictive factors for LRR. Tailored adjuvant treatment, taking these prognostic factors into account, is essential to improve patient outcomes and minimize unnecessary treatment-related toxicity.
Publisher
Heighten Science Publications Corporation
Reference27 articles.
1. 1. Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30. Erratum in: CA Cancer J Clin. 2005 Jul-Aug;55(4):259. Available from: https://doi.org/10.3322/canjclin.55.1.10
2. 2. Fung-Kee-Fung M, Dodge J, Elit L, Lukka H, Chambers A, Oliver T; Cancer Care Ontario Program in Evidence-based Care Gynecology Cancer Disease Site Group. Follow-up after primary therapy for endometrial cancer: a systematic review. Gynecol Oncol. 2006 Jun;101(3):520-529. Available from: https://doi.org/10.1016/j.ygyno.2006.02.011
3. 3. Odagiri T, Watari H, Hosaka M, Mitamura T, Konno Y, Kato T, et al. Multivariate survival analysis of the patients with recurrent endometrial cancer. J Gynecol Oncol. 2011 Mar 31;22(1):3-8. Available from: https://doi.org/10.3802/jgo.2011.22.1.3
4. 4. Turan T, Ureyen I, Karalok A, Tasci T, Turkmen O, Kocak O, et al. Pulmonary recurrence in patients with endometrial cancer. J Chin Med Assoc. 2016 Apr;79(4):212-220. Available from: https://doi.org/10.1016/j.jcma.2015.10.010
5. 5. Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS. Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Obstet Gynecol. 1991 Jul;78(1):63-69. Available from: https://pubmed.ncbi.nlm.nih.gov/2047070/