Features of recurrence of endometrioid type endometrial cancer of I stage
DOI:
https://doi.org/10.32471/exp-oncology.2312-8852.vol-43-no-4.17052Keywords:
chemotherapy, combined therapy, endometrial cancer, radiation therapy, relapse, surgical treatment, survivalAbstract
Summary. The aim of this study was to determine the rates of recurrences of stage I endometrial cancer (EC) and features of their localization depending on the clinical and pathological characteristics of the tumor and methods of patients’ treatment. Patients and Methods: The study included 968 patients with stage I endometrioid EC, who underwent surgical treatment in the Department of Oncogynecology of the National Cancer Institute in 2015–2019. Surveillance of patients lasted from January 2015 to December 2020, with a minimum follow-up period of 1 year from the date of surgery. Adjuvant radiation or chemotherapy was performed depending on the clinical and pathological characteristics of the EC case. Results: During the follow-up period, recurrences were observed in 7.0% of cases and were most often found in stage IC of low differentiation grade. It was found that during surgical treatment without adjuvant therapy relapses occurred in 12–36 months after the start of treatment, with adjuvant radiation therapy — in 6–18 months, and with adjuvant chemotherapy — in 32–60 months. Recurrences most often occurred in patients with EC who underwent surgical treatment in combination with chemotherapy (p < 0.05). The lowest number of recurrences was recorded among patients who underwent surgery as an only treatment. The best 5-year survival rate was observed in the group of patients with surgical treatment (93%), and the worst — in the patients treated with combination of surgery and chemotherapy (57%). In patients without recurrences, the survival rate after treatment was 97%, while in patients diagnosed with relapses, the survival rate was 65%. Conclusion: Despite the predominantly favorable course of EC stage I, some patients develop relapses. The rate and localization of recurrences depend on the histological structure of the tumor and treatment regimens of the EC patients.
References
Fedorenko Z, Goulak L, Gorokh Ye, et al. Cancer in Ukraine: incidence, mortality, activities of the oncological service 2020; 22: 146 p.
National Cancer Institute. Endometrial cancer treatment Physician Data Query (PDQ). 2021. http://www.cancer.gov/ cancertopics/pdq/treatment/endometrial/healthprofessional
Colombo N, Creutzberg C, Amant F, et al. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Int J Gynecol Cancer 2016; 26: 2–30. https://doi.org/10.1093/annonc/mdv484
ACOG. ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer. Obstet Gynecol 2005; 106: 413Y425. https://doi.org/10.1097/00006250-200508000-00050
Bendifallah S, Canlorbe G, Collinet P, et al. Just how accurate are the major risk stratification systems for early-stage endometrial cancer? Br J Cancer 2015; 112: 793–801. https://doi.org/10.1038/bjc.2015.35
Brennan DJ, Hackethal A, Mann KP, et al. Serum HE4 detects recurrent endometrial cancer in patients undergoing routine clinical surveillance. BMC Cancer 2015; 15: 33. https://doi.org/10.1186/s12885-015-1028-0
Harrison RF, He W, Fu S, et al. National patterns of care and fertility outcomes for reproductive-aged women with endometrial cancer or atypical hyperplasia. Am J Obstet Gynecol 2019; 221: 474.e1–11. doi:10.1016/j.ajog.2019.05.029
Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 2021; 31: 12–39. https://doi.org/10.1136/ijgc-2020-002230
Androutsopoulos G, Michail G, Adonakis G, et al. Current treatment approach of endometrial cancer. Int J Clin Ther Diagn 2015; S1(3): 8–11. doi:10.19070/2332-2926-SI01003
Colombo N, Preti E, Landoni F, et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24: vi33Yvi38. https://doi.org/10.1093/annonc/mdt353
de Boer SM, Nout RA, Jürgenliemk-Schulz IM, et al. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: results from the randomized PORTEC-2 trial. Int J Radiat Oncol Biol Phys 2015; 93: 797–809. https://doi.org/10.1016/j.ijrobp.2015.08.023
Nout RA, Smit VTHBM, Putter H, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non- inferiority, randomised trial. Lancet 2010; 375: 816–23. https://doi.org/10.1038/s41416-018-0310-8
Creutzberg CL, Nout RA, Lybeert MLM, et al. Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma. Int J Radiat Oncol Biol Phys 2011; 81: e631–8. https://doi.org/10.1016/j.ijrobp.2011.04.013
Matei D, Filiaci VL, Randall M, et al. A rando¬mized phase III trial of cisplatin nd tumor volume directed irradiation followed by carboplatin and paclitaxel vs. carboplatin and paclitaxel for optimally debulked, advanced endometrial carcinoma. J Clin Oncol 2017; 35: 5505. doi: https://doi.org/10.1200/JGO.17.00146
de Boer SM, Powell ME, Mileshkin L, et al. Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol 2016; 17: 1114–26. https://doi.org/10.1016/S1470-2045(16)30120-6
Sorbe B, Horvath G, Andersson H, et al. External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium-risk endometrial carcinoma — a prospective randomized study. Int J Radiat Oncol Biol Phys 2012; 82: 1249–55. doi:10.1016/j.ijrobp.2011.04.014
Randall ME, Filiaci V, McMeekin DS, et al. Phase III trial: adjuvant pelvic radiation therapy versus vaginal brachytherapy plus paclitaxel/carboplatin in high-Intermediate and high-risk early stage endometrial cancer. J Clin Oncol 2019; 37: 1810–8. https://doi.org/10.1200/JCO.18.01575
Matei D, Filiaci V, Randall ME, et al. Adjuvant chemotherapy plus radiation for locally advanced endometrial cancer. N Engl J Med 2019; 380: 2317–26. https://doi.org/10.1056/NEJMoa1813181
de Boer SM, Powell ME, Mileshkin L, et al. Adjuvant chemoradiotherapy versus radiotherapy alone in women with high-risk endometrial cancer (PORTEC-3): patterns of recurrence and post-hoc survival analysis of a randomised phase 3 trial. Lancet Oncol 2019; 20: 1273–85. https://doi.org/10.1016/S1470-2045(18)30079-2
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