Factors predicting recurrent endometrial cancer

Objectives: The aim of this study was to identify (prognostic) factors that may predict the development of recurrent endometrial cancer and may improve the choice of adjuvant therapy subsequently. Methods: Data of all patients, diagnosed with primary endometrial cancer in Orbis Medical Center Sittard between 2002 and 2010, were analyzed retrospectively. Cox regression analysis was performed for identification of independent prognostic factors; survival was calculated by using the Kaplan-Meier method. Study design: Data of all patients, diagnosed with primary endometrial cancer in Orbis Medical Center Sittard between 2002 and 2010, were analyzed retrospectively. Cox regression analysis was performed for identification of independent prognostic factors; survival was calculated by using the Kaplan-Meier method. Multiple factors were associated with recurrence. Age, histological type and progesteron receptor expression (PR) were identified as independent prognostic factors. Risk profile (according to the PORTEC-1 study) and PR were also independent prognostic factors. Furthermore, PR (p < 0.001) and histological type (p = 0.013) were associated with disease specific survival after recurrence. Conclusion: Although the survival of endometrial cancer is good, the prognosis of recurrent disease is poor. Recurrence of endometrial cancer and disease free survival rates are associated with several (independent) factors. The effect of adjuvant treatment may improve through more sufficient selection of patients by using the new prognostic factors and through better selection of the type of adjuvant therapy. Key words: Endometrial cancer, recurrence, survival, prognostic factors, progesterone receptor expression.

[1]  P. Altevogt,et al.  L1CAM in early-stage type I endometrial cancer: results of a large multicenter evaluation. , 2013, Journal of the National Cancer Institute.

[2]  Tjalling Bosse,et al.  Improved risk assessment of endometrial cancer by combined analysis of MSI, PI3K-AKT, Wnt/β-catenin and P53 pathway activation. , 2012, Gynecologic oncology.

[3]  K. Thiel,et al.  Progesterone: the ultimate endometrial tumor suppressor , 2011, Trends in Endocrinology & Metabolism.

[4]  M. Kaneuchi,et al.  Multivariate survival analysis of the patients with recurrent endometrial cancer , 2011, Journal of gynecologic oncology.

[5]  J. Schorge,et al.  Defining Prognostic Variables in Recurrent Endometrioid Endometrial Cancer: A 15-Year Single-Institution Review , 2011, International Journal of Gynecologic Cancer.

[6]  C. Mathers,et al.  Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 , 2010, International journal of cancer.

[7]  T. Kubota,et al.  Predictive factors for prolonged survival in recurrent endometrial carcinoma: Implications for follow-up protocol. , 2010, Gynecologic oncology.

[8]  S. Pecorelli.  Corrigendum to “Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium” , 2010 .

[9]  N. Yaegashi,et al.  Endometrioid uterine cancer: histopathological risk factors of local and distant recurrence. , 2009, Gynecologic oncology.

[10]  C. Vipupinyo,et al.  Prognostic significance of ER, PR, Ki67, c-erbB-2, and p53 in endometrial carcinoma. , 2008, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[11]  D. Mutch,et al.  Management of Endometrial Cancer , 2008, Women's health.

[12]  S. Pecorelli,et al.  History of the FIGO cancer staging system , 2008, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[13]  M. Quinn,et al.  Prognostic factors for recurrence in patients with FIGO stage I and II, intermediate or high risk endometrial cancer , 2008, Acta obstetricia et gynecologica Scandinavica.

[14]  C. Burger,et al.  Recurrent endometrial cancer: a retrospective study. , 2007, European journal of obstetrics, gynecology, and reproductive biology.

[15]  R. Reznek,et al.  Recurrent endometrial cancer: patterns of recurrent disease and assessment of prognosis. , 2007, Clinical radiology.

[16]  T. Oliver,et al.  Follow-up after primary therapy for endometrial cancer: a systematic review. , 2006, Gynecologic oncology.

[17]  E. Topuz,et al.  Evaluation of prognostic factors and comparison of systemic treatment modalities in patients with recurrent or metastatic endometrial carcinoma , 2006, Medical oncology.

[18]  F. Bray,et al.  Endometrial Cancer Incidence Trends in Europe: Underlying Determinants and Prospects for Prevention , 2005, Cancer Epidemiology Biomarkers & Prevention.

[19]  A. Romano,et al.  Aberrations in the progesterone receptor gene and the risk of recurrent endometrial carcinoma , 2005, The Journal of pathology.

[20]  Patrick Neven,et al.  Endometrial cancer. , 2005, Lancet.

[21]  A. Gadducci,et al.  Factors influencing survival in endometrial cancer relapsing patients: a Cooperation Task Force (CTF) study , 2003, International Journal of Gynecologic Cancer.

[22]  H. Ngan,et al.  FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. , 2000, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[23]  P. Koper,et al.  Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. , 2000 .

[24]  P. Koper,et al.  Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial , 2000, The Lancet.

[25]  S. Ingram,et al.  The predictive value of progesterone receptor levels in endometrial cancer. , 1989, International journal of radiation oncology, biology, physics.