Share This Article:

Patterns of Recurrence and Their Significance in Patients with Endometrial Carcinoma
—For Improved Follow-Up after Initial Treatment

Abstract Full-Text HTML XML Download Download as PDF (Size:304KB) PP. 154-159
DOI: 10.4236/ss.2013.42030    3,855 Downloads   5,223 Views  

ABSTRACT

Objectives: The aim of this study was to identify the patterns of recurrence and their significance in patients with endometrial carcinoma (EMCA). Patients and Methods: After a search of the medical records from single institutions, a total of 49 patients with relapsed endometrial carcinoma were retrospectively evaluated. Various clinical information was examined, including the site of recurrence, detection procedure, and presence or absence of any symptom at the time of recurrence. Furthermore, the postrecurrence survival analysis was based on the Kaplan-Meier method. Results: The median follow-up period of all patients was 39.4 months (5.8 - 293.1). In all, twenty-five (51.0%) patients experienced recurrence within 12 months after the final treatment. At the time of recurrence, 15 (30.6%) and 34 (69.4%) patients were symptomatic and asymptomatic, respectively. Among the 34 asymptomatic patients, recurrence was detected by CT scan in 14 (28.6%), tumor markers alone in 14 (28.6%), and pelvic examination/ultrasound scan in 5 (10.2%). There was no relapsed case detected by vaginal vault cytology alone. The 5-year postrecurrence survival rates in symptomatic and asymptomatic patients were 57.5 and 36.6 months, respectively (P = 0.2973). After recurrence, 12 patients underwent debulking surgery, and 37 received salvage chemotherapy or radiotherapy. The postrecurrence survival of patients receiving surgery did not differ from that of those with chemotherapy/radiotherapy (P = 0.9198). Conclusion: Although imaging studies and tumor marker measurement contributed to the early detection of recurrence, they did not necessarily improve the prognosis postrecurrence.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

F. Utsumi, H. Kajiyama, K. Shibata, H. Mitsui, R. Sekiya, M. Mizuno, S. Suzuki, T. Umezu, E. Yamamoto and F. Kikkawa, "Patterns of Recurrence and Their Significance in Patients with Endometrial Carcinoma—For Improved Follow-Up after Initial Treatment," Surgical Science, Vol. 4 No. 2, 2013, pp. 154-159. doi: 10.4236/ss.2013.42030.

References

[1] A. Jemal, R. Siegel, E. Ward, et al., “Cancer Statistics, 2006,” CA: A Cancer Journal for Clinicians, Vol. 56, No. 2, 2006, pp. 106-130. doi:10.3322/canjclin.56.2.106
[2] M. Fung-Kee-Fung, J. Dodge, L. Elit, H. Lukka, A. Chambers and T. Oliver, “Follow-Up after Primary Therapy for Endometrial Cancer: A Systematic Review,” Gynecologic Oncology, Vol. 101, No. 3, 2006, pp. 520-529. doi:10.1016/j.ygyno.2006.02.011
[3] W. T. Creasman, C. P. Morrow, B. N. Bundy, H. D. Homesley, J. E. Graham and P. B. Heller, “Surgical Pathologic Spread Patterns of Endometrial Cancer. A Gynecologic Oncology Group Study,” Cancer, Vol. 60, No. S8, 1987, pp. 2035-2041. doi:10.1002/1097-0142(19901015)60:8+<2035::AID-CNCR2820601515>3.0.CO;2-8
[4] W. A. Tjalma, P. A. van Dam, A. P. Makar and D. J. Cruickshank, “The Clinical Value and the Cost-Effectiveness of Follow-Up in Endometrial Cancer Patients,” International Journal of Gynecological Cancer, Vol. 14, No. 5, 2004, pp. 931-937. doi:10.1111/j.1048-891X.2004.014532.x
[5] E. Sartori, B. Pasinetti, L. Carrara, A. Gambino, F. Odicino and S. Pecorelli, “Pattern of Failure and Value of Follow-Up Procedures in Endometrial and Cervical Cancer Patients,” Gynecologic Oncology, Vol. 107, No. 1, 2007, pp. S241-S247. doi:10.1016/j.ygyno.2007.07.025
[6] C. P. Morrow, B. N. Bundy, R. J. Kurman, et al., “Relationship between Surgical-Pathological Risk Factors and Outcome in Clinical Stage I and II Carcinoma of the Endometrium: A Gynecologic Oncology Group Study,” Gynecologic Oncology, Vol. 40, No. 1, 1991, pp. 55-65. doi:10.1016/0090-8258(91)90086-K
[7] I. Otsuka, M. Uno, A. Wakabayashi, S. Kameda, H. Udagawa and T. Kubota, “Predictive Factors for Prolonged Survival in Recurrent Endometrial Carcinoma: Implications for Follow-Up Protocol,” Gynecologic Oncology, Vol. 119, No. 3, pp. 506-510. doi:10.1016/j.ygyno.2010.08.013
[8] A. Berchuck, C. Anspach, A. C. Evans, et al., “Postsurgical Surveillance of Patients with FIGO Stage I/II Endometrial Adenocarcinoma,” Gynecologic Oncology, Vol. 59, No. 1, 1995, pp. 20-24. doi:10.1006/gyno.1995.1262
[9] E. Podczaski, P. Kaminski, K. Gurski, et al., “Detection and Patterns of Treatment Failure in 300 Consecutive Cases of ‘Early’ Endometrial Cancer after Primary Surgery,” Gynecologic Oncology, Vol. 47, No. 3, 1992, pp. 323-327. doi:10.1016/0090-8258(92)90134-5
[10] H. B. Salvesen, L. A. Akslen, T. Iversen and O. E. Iversen, “Recurrence of Endometrial Carcinoma and the Value of Routine Follow up,” BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 104, No. 11, 1997, pp. 1302-1307. doi:10.1111/j.1471-0528.1997.tb10979.x
[11] I. Otsuka, M. Uno, A. Wakabayashi, S. Kameda, H. Udagawa and T. Kubota, “Predictive Factors for Prolonged Survival in Recurrent Endometrial Carcinoma: Implications for Follow-Up Protocol,” Gynecologic Oncology, Vol. 119, No. 3, 2010, pp. 506-510. doi:10.1016/j.ygyno.2010.08.013
[12] Y. Ueda, T. Enomoto, T. Egawa-Takata, et al., “Endometrial Carcinoma: Better Prognosis for Asymptomatic Recurrences than for Symptomatic Cases Found by Routine Follow-Up,” International Journal of Clinical Oncology, Vol. 15, No. 4, pp. 406-412. doi:10.1007/s10147-010-0080-7
[13] A. G. Shumsky, G. C. Stuart, P. M. Brasher, J. G. Nation, D. I. Robertson and S. Sangkarat, “An Evaluation of Routine Follow-Up of Patients Treated for Endometrial Carcinoma,” Gynecologic Oncology, Vol. 55, No. 2, 1994, pp. 229-233. doi:10.1006/gyno.1994.1282
[14] J. M. Reddoch, T. W. Burke, M. Morris, C. Tornos, C. Levenback and D. M. Gershenson, “Surveillance for Recurrent Endometrial Carcinoma: Development of a Follow-Up Scheme,” Gynecologic Oncology, Vol. 59, No. 2, 1995, pp. 221-225. doi:10.1006/gyno.1995.0012
[15] P. Morice, C. Levy-Piedbois, S. Ajaj, et al., “Value and Cost Evaluation of Routine Follow-Up for Patients with Clinical Stage I/II Endometrial Cancer,” European Journal of Cancer, Vol. 37, No. 8, 2001, pp. 985-990. doi:10.1016/S0959-8049(01)00066-1
[16] O. O. Agboola, E. Grunfeld, D. Coyle and G. A. Perry, “Costs and Benefits of Routine Follow-Up after Curative Treatment for Endometrial Cancer,” CMAJ, Vol. 157, No. 7, 1997, pp. 879-886.
[17] C. J. Smith, M. Heeren, J. L. Nicklin, et al., “Efficacy of Routine Follow-Up in Patients with Recurrent Uterine Cancer,” Gynecologic Oncology, Vol. 107, No. 1, 2007, pp. 124-129. doi:10.1016/j.ygyno.2007.06.002
[18] J. R. Dijkstra, G. H. De Bock and M. J. Mourits, “The Clinical Value and the Cost-Effectiveness of Follow-Up in Endometrial Cancer Patients,” International Journal of Gynecological Cancer, Vol. 15, No. 5, 2005, pp. 991-992. doi:10.1111/j.1525-1438.2005.00257.x

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.