Survival outcomes improved in contemporary cohort of patients with pelvic or abdominal recurrence after treatment for Stage I/II endometrial carcinoma
Identifieur interne : 003773 ( Pmc/Curation ); précédent : 003772; suivant : 003774Survival outcomes improved in contemporary cohort of patients with pelvic or abdominal recurrence after treatment for Stage I/II endometrial carcinoma
Auteurs : Melody J. Xu [États-Unis] ; Christina Chu [États-Unis] ; Stephen Rubin [États-Unis] ; Lilie L. Lin [États-Unis]Source :
- American journal of clinical oncology [ 0277-3732 ] ; 2015.
Abstract
Pelvic and abdominal recurrences in Stage I/II endometrial carcinoma are associated with poor outcomes, yet prognostic factors for survival after recurrence are not well-described. Herein we identify patients with pelvic or abdominal recurrence after surgery for Stage I/II endometrial carcinoma and describe symptoms at presentation, prognostic factors, and salvage treatment toxicity.
This is a retrospective cohort of 20 consecutively treated patients with recurrence after treatment for Stage I/II endometrial carcinoma followed by our Institution’s Radiation Oncology Department from 1998-2015.
The median time to pelvic or abdominal recurrence was 18.1 months (range, 4.2-59.6 months), with 50% of recurrences at extra-nodal locations. Two year progression-free survival (PFS) was 44% and 2 year overall survival (OS) was 82%. Salvage treatments varied widely, including chemotherapy and radiation therapy (RT) (7), surgery and RT (3), and surgery, chemotherapy, and RT (3). On univariate analysis of PFS, symptoms at recurrence (p=0.04) and extra-nodal recurrences (p<0.01) were found to be statistically significant negative prognosticators for PFS. On univariate analysis of OS, increasing age at recurrence and presence of symptoms were found to have a trend toward statistically significant association with negative OS outcomes (p=0.08 and p=0.10, respectively).
Our study demonstrates long-term survival for pelvic or abdominal recurrences is possible with curative salvage therapy. The presence of symptoms is a negative prognostic factor in treatment outcome and imaging may be effective for diagnosis in symptomatic and asymptomatic patients. Larger studies need to be performed to confirm these findings.
Url:
DOI: 10.1097/COC.0000000000000212
PubMed: 26237194
PubMed Central: 4733581
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<author><name sortKey="Xu, Melody J" sort="Xu, Melody J" uniqKey="Xu M" first="Melody J." last="Xu">Melody J. Xu</name>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">Pelvic and abdominal recurrences in Stage I/II endometrial carcinoma are associated with poor outcomes, yet prognostic factors for survival after recurrence are not well-described. Herein we identify patients with pelvic or abdominal recurrence after surgery for Stage I/II endometrial carcinoma and describe symptoms at presentation, prognostic factors, and salvage treatment toxicity.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">This is a retrospective cohort of 20 consecutively treated patients with recurrence after treatment for Stage I/II endometrial carcinoma followed by our Institution’s Radiation Oncology Department from 1998-2015.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The median time to pelvic or abdominal recurrence was 18.1 months (range, 4.2-59.6 months), with 50% of recurrences at extra-nodal locations. Two year progression-free survival (PFS) was 44% and 2 year overall survival (OS) was 82%. Salvage treatments varied widely, including chemotherapy and radiation therapy (RT) (7), surgery and RT (3), and surgery, chemotherapy, and RT (3). On univariate analysis of PFS, symptoms at recurrence (p=0.04) and extra-nodal recurrences (p<0.01) were found to be statistically significant negative prognosticators for PFS. On univariate analysis of OS, increasing age at recurrence and presence of symptoms were found to have a trend toward statistically significant association with negative OS outcomes (p=0.08 and p=0.10, respectively).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our study demonstrates long-term survival for pelvic or abdominal recurrences is possible with curative salvage therapy. The presence of symptoms is a negative prognostic factor in treatment outcome and imaging may be effective for diagnosis in symptomatic and asymptomatic patients. Larger studies need to be performed to confirm these findings.</p>
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<journal-id journal-id-type="nlm-ta">Am J Clin Oncol</journal-id>
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<contrib-group><contrib contrib-type="author"><name><surname>Xu</surname>
<given-names>Melody J.</given-names>
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<degrees>M.D.</degrees>
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<contrib contrib-type="author"><name><surname>Chu</surname>
<given-names>Christina</given-names>
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<degrees>M.D.</degrees>
<xref ref-type="aff" rid="A2">2</xref>
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<contrib contrib-type="author"><name><surname>Rubin</surname>
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<contrib contrib-type="author"><name><surname>Lin</surname>
<given-names>Lilie L.</given-names>
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<degrees>M.D.</degrees>
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<xref ref-type="corresp" rid="CR1">*</xref>
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<aff id="A1"><label>1</label>
Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA</aff>
<aff id="A2"><label>2</label>
Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA</aff>
<author-notes><corresp id="CR1"><label>*</label>
Corresponding Author: Lilie L. Lin, MD, Department of Radiation Oncology, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd., PCAM/TRC 4West, Philadelphia, PA 19104, Office: 215-662-6515, Fax: 215-349-5445, <email>lin@xrt.upenn.edu</email>
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<pub-date pub-type="nihms-submitted"><day>6</day>
<month>7</month>
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<pub-date pub-type="epub"><day>31</day>
<month>7</month>
<year>2015</year>
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<pub-date pub-type="pmc-release"><day>31</day>
<month>1</month>
<year>2017</year>
</pub-date>
<elocation-id>10.1097/COC.0000000000000212</elocation-id>
<abstract><sec id="S1"><title>Objectives</title>
<p id="P1">Pelvic and abdominal recurrences in Stage I/II endometrial carcinoma are associated with poor outcomes, yet prognostic factors for survival after recurrence are not well-described. Herein we identify patients with pelvic or abdominal recurrence after surgery for Stage I/II endometrial carcinoma and describe symptoms at presentation, prognostic factors, and salvage treatment toxicity.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">This is a retrospective cohort of 20 consecutively treated patients with recurrence after treatment for Stage I/II endometrial carcinoma followed by our Institution’s Radiation Oncology Department from 1998-2015.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The median time to pelvic or abdominal recurrence was 18.1 months (range, 4.2-59.6 months), with 50% of recurrences at extra-nodal locations. Two year progression-free survival (PFS) was 44% and 2 year overall survival (OS) was 82%. Salvage treatments varied widely, including chemotherapy and radiation therapy (RT) (7), surgery and RT (3), and surgery, chemotherapy, and RT (3). On univariate analysis of PFS, symptoms at recurrence (p=0.04) and extra-nodal recurrences (p<0.01) were found to be statistically significant negative prognosticators for PFS. On univariate analysis of OS, increasing age at recurrence and presence of symptoms were found to have a trend toward statistically significant association with negative OS outcomes (p=0.08 and p=0.10, respectively).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our study demonstrates long-term survival for pelvic or abdominal recurrences is possible with curative salvage therapy. The presence of symptoms is a negative prognostic factor in treatment outcome and imaging may be effective for diagnosis in symptomatic and asymptomatic patients. Larger studies need to be performed to confirm these findings.</p>
</sec>
</abstract>
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<kwd>abdominal recurrence</kwd>
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