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KMID : 1137020170280050002
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Journal of Gynecologic Oncology
2017 Volume.28 No. 5 p.2 ~ p.2
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Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone
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Ozkan Nazli Topfedaisi
Meydanli Mehmet Mutlu
Sari Mustafa Erkan
Demirkiran Fuat
Kahramanoglu Ilker
Bese Tugan
Arvas Macit
Sahin Hanifi
Haberal Ali
Celik Husnu
Coban Gonca
Oge Tufan
Yalcin Omer Tarik
Akbayir Ozgur
Erdem Baki
Numanoglu Ceyhun
Ozgul Nejat
Boyraz Gokhan
Salman Mehmet Coskun
Yuce Kunter
Dede Murat
Yenen Mufit Cemal
Taskin Salih
Altin Duygun
Ortac Ugur Firat
Ayik Hulya Aydin
Simsek Tayup
Gungor Tayfun
Gungorduk Kemal
Sanci Muzaffer
Ayhan Ali
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Abstract
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Objective: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone.
Methods: A multicenter, retrospective department database review was performed to identify patients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected.
Results: We identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5?34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7?105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR ≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65?43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69?12.58; p=0.003) were significant predictors.
Conclusion: Low-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.
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KEYWORD
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Endometrial Neoplasms, Recurrence, Local Neoplasm Recurrence, Survival Analysis
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