Patterns of FIRST recurrence of stage IIIC1 endometrial cancer with no PARAAORTIC nodal assessment Journal Article
| Authors: | Aloisi, A.; Casanova, J. M.; Tseng, J. H.; Seader, K. A.; Nguyen, N. T.; Alektiar, K. M.; Makker, V.; Chiang, S.; Soslow, R. A.; Leitao, M. M. Jr; Abu-Rustum, N. R. |
| Article Title: | Patterns of FIRST recurrence of stage IIIC1 endometrial cancer with no PARAAORTIC nodal assessment |
| Abstract: | Objective: To assess the rates and distribution of first recurrence in patients with FIGO stage IIIC1 endometrial cancer (EC) who did not undergo paraaortic dissection at surgical staging. Methods: We retrospectively selected all (n = 207) stage IIIC1 patients treated at a single institution from 5/1993–1/2017. Sites of first recurrence were identified, disease-free (DFS) and overall survival (OS) calculated, multivariate logistic regression performed to identify factors associated with recurrence. Results: Three-year DFS and OS were 66.5% and 85.7%, respectively. The most common histology was endometroid (64.2%). Three-year DFS was 81% (SE±3.8%) endometrioid vs. 39.5% (SE±6.6%) non-endometrioid (P < 0.001). Three-year OS was 96.9% (SE±1.8%) endometrioid vs. 65.6% (SE±6.7%) non-endometrioid (P < 0.001). Sixty-two (30.1%) patients recurred. Patterns of recurrence were: 14 (8.3%) multiple sites, 17 (8.2%) abdominal, 14 (6.8%) extra-abdominal, 17 (8.3%) isolated nodal (8 of these (3.9%) paraaortic). Patients with isolated tumor cells (ITCs) in lymph nodes only had 12/71 (17%) recurrence rate vs. 50/135 (37%) for patients with micro−/macrometastasis. On univariate analysis, grade (HR 4.67 95%CI 1.5–14.5, P = 0.008), histology (HR 4.9 95%CI 2.6–9.3, P < 0.001), myometrial invasion (HR 1.9 95%CI 1.04–3.5, P = 0.04), pelvic washing (HR 2.2 95%CI 1.1–4.5, P = 0.03), tumor volume in pelvic LNs (ITC vs. micro−/macrometastasis; HR 0.3 95%CI 0.2–0.7, P = 0.003) were associated with recurrence. On multivariate analysis, only histology was associated with recurrence (HR 7.88 95%CI 3.43–18.13, P < 0.001). Conclusions: Isolated paraaortic recurrence in stage IIIC1 EC is uncommon. Micro−/macrometastasis were associated with twice the recurrence rate compared to ITC. These data will help clinicians counsel patients with stage IIIC1 EC regarding paraaortic assessment. © 2018 Elsevier Inc. |
| Keywords: | cancer chemotherapy; controlled study; aged; cancer surgery; major clinical study; overall survival; cancer recurrence; multimodality cancer therapy; cancer radiotherapy; disease free survival; cancer staging; recurrence risk; follow up; endometrial cancer; antineoplastic agent; endometrium carcinoma; paraaortic lymph node; pelvis lymph node; cancer grading; endometrium cancer; tumor volume; recurrence; retrospective study; histology; cancer hormone therapy; body mass; lymph node; micrometastasis; disease free interval; external beam radiotherapy; ca 125 antigen; clinical outcome; isolated tumor cells; lymph vessel metastasis; human; female; priority journal; article; itc; stage iiic1 |
| Journal Title: | Gynecologic Oncology |
| Volume: | 151 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2018-12-01 |
| Start Page: | 395 |
| End Page: | 400 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2018.09.021 |
| PROVIDER: | scopus |
| PMCID: | PMC6281769 |
| PUBMED: | 30286945 |
| DOI/URL: | |
| Notes: | Gynecol. Oncol. -- Cited By :2 -- Export Date: 2 January 2019 -- Article -- CODEN: GYNOA C2 - 30286945 -- Source: Scopus |
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