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Non-endometrioid endometrial cancer: analysis of recurrence pattern and identification of prognostic and treatment factors affecting recurrence and survival

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Abstract

Purpose

We investigated the characteristics of recurrence pattern and survival of patients with non-endometrioid endometrial cancer (NEEC) and attempted to identify prognostic and treatment factors affecting disease-free survival (DFS) and overall survival (OS) of these patients.

Methods

Fifty-seven patients with histologically confirmed International Federation of Gynecology and Obstetrics (FIGO) stage IA–IVA NEEC from February 2003 to December 2021 were retrospectively analyzed.

Results

The 5‑year DFS and OS rates of the total cohort were 50.6% and 56.1%, respectively. Recurrence occurred in 28 patients (49.1%) during follow-up, and the most common recurrence pattern was distant metastasis (DM; 78.6% of total recurrences). The occurrence of relapse significantly reduced 5‑year OS (recurrence group vs. non-recurrence group: 12.5% vs. 100%; p < 0.001). In univariate analysis, adjuvant radiotherapy (RT) group showed significantly higher 5‑year DFS (56.7% vs. 37.9%; p = 0.04), local recurrence-free survival (91.6% vs. 50.5%; p = 0.01), and regional recurrence-free survival (88.2% vs. 56.5%; p < 0.01) than the non-RT group. In multivariate analysis, advanced FIGO stage was identified as a negative prognostic factor for DFS and OS. Lymphovascular space invasion (LVSI) and adjuvant RT were independent prognostic factors for DFS.

Conclusion

The most common recurrence pattern observed in patients with NEEC was DM. FIGO stage and LVSI were identified as prognostic factors for survival, and RT was identified as a therapeutic modality that could increase DFS. To improve the OS of patients with NEEC, the addition of effective chemotherapy that can reduce DM may be important.

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Acknowledgements

The authors would like to thank the Department of Obstetrics and Gynecology of Incheon St. Mary’s Hospital, which contributed to the treatment of the patients.

Funding

No funds, grants, or other support was received for this study.

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Authors and Affiliations

  1. Department of Radiation Oncology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Republic of)

    So Jung Lee, Hye Jin Kang, Yoo-Kang Kwak, Myungsoo Kim & Jisang Kim

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  1. So Jung Lee
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  2. Hye Jin Kang
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  3. Yoo-Kang Kwak
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  4. Myungsoo Kim
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  5. Jisang Kim
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Corresponding author

Correspondence to Hye Jin Kang.

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Conflict of interest

So Jung Lee, Hye Jin Kang, Yoo-Kang Kwak, Myungso Kim, and Jisang Kim declare that they have no competing interests.

Ethical standards

This study was approved by the Institutional Review Board of the Catholic Medical Center Ethics Committee (IRB no. OC22RASI0123).

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Lee, S.J., Kang, H.J., Kwak, YK. et al. Non-endometrioid endometrial cancer: analysis of recurrence pattern and identification of prognostic and treatment factors affecting recurrence and survival. Strahlenther Onkol 199, 828–837 (2023). https://doi.org/10.1007/s00066-023-02061-1

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  • DOI: https://doi.org/10.1007/s00066-023-02061-1

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