TITLE:
Patterns of Recurrence and Their Significance in Patients with Endometrial Carcinoma—For Improved Follow-Up after Initial Treatment
AUTHORS:
Fumi Utsumi, Hiroaki Kajiyama, Kiyosumi Shibata, Hiroko Mitsui, Ryuichiro Sekiya, Mika Mizuno, Shiro Suzuki, Tomokazu Umezu, Eiko Yamamoto, Fumitaka Kikkawa
KEYWORDS:
Endometrial Carcinoma; Recurrence Site; Postrecurrence Survival; Symptomatic; Vaginal Vault Cytology
JOURNAL NAME:
Surgical Science,
Vol.4 No.2,
February
19,
2013
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.