2022-RA-197-ESGO Risk factors and patterns of recurrence in patients with low-risk endometrial cancer. (20th October 2022)

• Record Type: Journal Article
• Authors: Hwang, In Sun; Kim, Chaewon; Lee, Keun Ho; Yoo, Jigeun
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A91
• Page End: A92
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.205
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: More than half of all endometrial cancers are diagnosed as early stage low-risk, and are treated with surgery alone. However, 3–10% of them experience relapse. The aim of this study is to evaluate risk factors and patterns of recurrence in patients with low-risk endometrial cancer. Methodology: Patients who diagnosed with endometrial cancer after hysterectomy at Seoul St. Mary's hospital and St. Vincent hospital from 2009 to 2019 were identified. The inclusion criteria are as follows: FIGO stage Ia; endometrioid adenocarcinoma grade 1–2; and no lymphovascular space invasion. Exclusion criteria are those who received postoperative adjuvant treatment. Survival was analyzed using Kaplan-Meier method, and significance was confirmed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazards regression method. Results: A total of 391 patients were included and the median follow-up period was 53 months. Of those, 22 (5.6%) had recurrence, and 5 (1.3%) died of disease. Multivariate analysis identified menopause and tumor grade 2 as independent risk factors for recurrence. Of note, 10 of 62 patients (16.1%) with both risk factors relapsed, suggesting that postoperative adjuvant therapy could be considered for these patients. The most common sites of recurrence are vaginal stump and lung (7/22, 31.8%). In vaginal stump recurrence, the median time to recurrence was shorter than that of other sites (30 vs 15 months, p = 0.002), and 71.4% (5/7) were isolated recurrence. Median time to recurrence was 31 and 25 months for G1 and G2, respectively (p = 0.130). Conclusion: We identified menopause and tumor grade 2 as risk factors for recurrence in early stage low-risk endometrial cancer. Since lung is one of the most common sites of recurrence and usually does not develop symptoms, routine check during follow-up is required.