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Prognostic Value and Risk Factors of Peritoneal Carcinomatosis Recurrence for Patients with Endometrial Cancer: A Multicenter Study from the FRANCOGYN Group

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The prognosis for patients with endometrial cancer (EC) peritoneal carcinomatosis (PC) recurrence has received little study. This study aimed to determine specific risk factors and prognosis of EC with PC recurrence (PCR) versus no PC recurrence (NPCR).

Methods

Data of all patients with EC who received primary surgical treatment between January 2000 and February 2017 were abstracted from the French FRANCOGYN Research Group database. Clinical and pathologic variables were compared between the two groups (PCR vs. NPCR). Multivariate analysis was performed to define prognostic factors for peritoneal recurrence. Overall survivals (OS) of patients after recurrence were compared using the Kaplan–Meier method.

Results

The study analyzed 1466 patients, and 257 of these patients (17.5%) had recurrence. At presentation, 63 of these patients had PC. International Federation of Gynecology and Obstetrics (FIGO) stages 3 and 4 disease were significantly associated with PCR versus NPCR (odds ratio 2.24; 95% confidence interval 1.23–4.07; p = 0.008). The death rate for the patients with PC was 47.6%, with a median survival of 12 months after diagnosis of recurrence. According to the histologic subtype, OS was 29 months (Q1–Q3, 13–NA) for endometrioid carcinomas, 7.5 months (Q1–Q3, 4–15) for serous carcinomas, and 10 months (Q1–Q3, 5–15) for clear cell carcinomas. Chemotherapy for treatment of PCR was associated with improved OS after recurrence (OSAR; p = 0.0025).

Conclusion

An initial advanced stage of EC is a risk factor for PCR. For women with PCR, a diagnosis of type 1 EC recurrence more than 12 months after the initial treatment and management of PCR with chemotherapy is associated with improved OSAR. Prospective studies are needed to determine the precise optimal management required in this clinical situation and to assess the relevance of biomarkers to predict the risk of PCR for EC patients.

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Author information

Authors and Affiliations

  1. AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France

    A. Gaudet Chardonnet MD, H. Azaïs MD, PhD, C. Uzan MD, PhD & G. Canlorbe MD, PhD

  2. Service de Chirurgie Gynécologique et Mammaire, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France

    M. Ballester MD, PhD

  3. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France

    E. Raimond MD, PhD & O. Graesslin MD, PhD

  4. AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynaecology and Obstetrics, Tenon University Hospital, Paris, France

    S. Bendifallah MD, PhD & E. Daraï MD, PhD

  5. INSERM UMR_S_938, “Cancer Biology and Therapeutics,” Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France

    S. Bendifallah MD, PhD, E. Daraï MD, PhD, C. Uzan MD, PhD & G. Canlorbe MD, PhD

  6. Institut Universitaire de Cancérologie (IUC), Sorbonne University, Paris, France

    S. Bendifallah MD, PhD, E. Daraï MD, PhD, C. Uzan MD, PhD & G. Canlorbe MD, PhD

  7. Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Tours, France

    L. Ouldamer MD, PhD

  8. Center de Lutte Contre le Cancer Georges François Leclerc, Dijon, France

    C. Coutant MD, PhD

  9. Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France

    C. Touboul MD, PhD & P. Collinet MD, PhD

  10. Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France

    P. Collinet MD, PhD

  11. AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Bondy, France

    A. Bricou MD, PhD

  12. Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France

    C. Huchon MD, PhD

  13. Service de Gynécologie, INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Université de Rennes 1, Hopital Sud, CHU de Rennes, Rennes, France

    V. Lavoue MD, PhD

  14. Service de Chirurgie et Oncologie Gynécologique et Mammaire, APHP, Université Paris Diderot Hôpital Bichat, Paris, France

    M. Koskas MD, PhD

Authors
  1. A. Gaudet Chardonnet MD
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  2. H. Azaïs MD, PhD
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  3. M. Ballester MD, PhD
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  5. S. Bendifallah MD, PhD
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  7. C. Coutant MD, PhD
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  8. O. Graesslin MD, PhD
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  9. C. Touboul MD, PhD
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  11. A. Bricou MD, PhD
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  12. C. Huchon MD, PhD
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  14. V. Lavoue MD, PhD
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  15. M. Koskas MD, PhD
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  16. C. Uzan MD, PhD
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  17. G. Canlorbe MD, PhD
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Corresponding author

Correspondence to G. Canlorbe MD, PhD.

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Gaudet Chardonnet, A., Azaïs, H., Ballester, M. et al. Prognostic Value and Risk Factors of Peritoneal Carcinomatosis Recurrence for Patients with Endometrial Cancer: A Multicenter Study from the FRANCOGYN Group. Ann Surg Oncol 28, 212–221 (2021). https://doi.org/10.1245/s10434-020-08812-z

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