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


Background: The aim of this study was to analyze the patterns of relapse and survival outcomes in NorthernThai women with recurrent endometrial cancer (EC). Materials and
Methods: Medical records were abstractedfrom EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sitesof first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations betweenthe clinicopathological variables and the rates of disease recurrence were determined.
Results: Among 1,204reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years andthe median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of theinitial 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-yearsurvival 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 thosewith DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantlydifferent in patients with local relapse when compared to those with DCSR (p=0.69).
Conclusions: Patients withrecurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSRoccurred 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.