Abstract
The overall rate of recurrence for endometrial cancer is approximately 10–15% with more than 50% cases occurring within 2 years of primary treatment. Women with recurrent endometrial cancer (REC) represent a heterogeneous group, with variable clinical profile and therapeutic response. Although the prognosis of endometrial cancer is largely good owing to its early detection, but the prognosis of recurrent disease remains grave, reflecting the biologically aggressive nature of recurrent disease. The therapeutic options available for REC are surgery, chemotherapy, radiotherapy, hormonal, and targeted therapy; a combination of the various modalities may also be given. Surgery is successful in women who have isolated recurrence in previously irradiated pelvis; Exenterative and non-exenterative procedures can be done to achieve complete cytoreduction. Radiation is most appropriate in women with local pelvic recurrence and no prior history of radiation therapy. Role of chemotherapy is mainly palliative and first-line therapy is platinum-based therapy. Hormonal therapy is advocated in women with positive ER/PR status with low-grade disease. Targeted therapy in the form of VEGFR inhibitors or mTOR inhibitors is a new addition to the armamentarium for managing REC.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Aalders JG, Abeler V, Kolstad P. Recurrent adenocarcinoma of the endometrium: a clinical and histopathological study of 379 patients. Gynecol Oncol. 1984;17:85–103.
Bradford LS, Rauh-Hain JA, Schorge J, Birrer MJ, Dizon DS. Advances in the management of recurrent endometrial cancer. Am J Clin Oncol. 2015;38(2):206–12.
Walker JL, Piedmonte MR, Spirtos NM, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009;27(32):5331–6.
Carlson MJ, Thiel KW, Leslie KK. Past, present and future of hormonal therapy in recurrent endometrial cancer. Int J Womens Health. 2014;6:429–35.
Del Carmen MG, Boruta DM, Schorge JO. Recurrent endometrial cancer. Clin Obstet Gynecol. 2011;54:266.
Koh WJ, Abu-Rustum NR, Bean S, et al. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2018;16(2):170–99.
Rauh-Hain JA, Del Carmen MG. Treatment for advanced and recurrent endometrial carcinoma combined modalities. Oncologist. 2010;15(8):852–61.
Morgan JD 3rd, Reddy S, Sarin P, et al. Isolated vaginal recurrences of endometrial carcinoma. Radiology. 1993;189:609–13.
Hoekstra CJ, Koper PC, Van Putten WL. Recurrent endometrial adenocarcinoma after surgery alone: prognostic factors and treatment. Rad Oncol. 1993;27:164–6.
McMeekin DS, Filiaci VL, Thigpen JT, et al. The relationship between histology and outcome in advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials: a Gynecologic Oncology Group study. Gynecol Oncol. 2007;106:16.
Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Endometrial cancer. Lancet. 2016;387(10023):1094–108.
Nout RA, Van de Poll-Franse LV, Lybeert ML, et al. Long-term outcome and quality of life of patients with endometrial carcinoma treated with or without pelvic radiotherapy in the post-operative radiation therapy in endometrial carcinoma 1 (PORTEC-1) trial. J Clin Oncol. 2011;29(13):1692–700.
Papadia A, Bellati F, Ditto A, et al. Surgical treatment of recurrent endometrial cancer: time for a paradigm shift. Ann Surg Oncol. 2015;22(13):4204.
Bristow RE, Santillan A, Zahurak ML, et al. Salvage cytoreductive surgery for recurrent endometrial cancer. Gynecol Oncol. 2006;103:281–7.
Schmidt AM, Imesch P, Fink D, Egger H. Pelvic exenteration for advanced and recurrent endometrial cancer: clinical outcomes of 40 patients. Int J Gynecol Can. 2016;26:716–21.
Creutzberg CL, van Putten WL, Koper PC, et al. Survival after relapse in patients with endometrial cancer: results from a randomized trial. Gynecol Oncol. 2003;89:201.
Huh WK, Straughn JM Jr, Mariani A, et al. Salvage of isolated vaginal recurrences in women with surgical stage I endometrial cancer: a multi-institutional experience. Inter J Gynecol Can. 2007;17:886.
Viswanathan AN, Cormack R, Holloway CL, et al. Magnetic resonance-guided interstitial therapy for vaginal recurrence of endometrial cancer. Int J Rad Oncol Biol Phys. 2006;66:91.
Thigpen JT, Brady MF, Homesley HD, et al. Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: a gynecologic oncology group study. J Clin Oncol. 2004;22(19):3902–8.
Aapro MS, Van Wijk FH, Bolis G, et al. European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group. Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group. Ann Oncol. 2003;14(3):441–8.
Fleming GF, Brunetto VL, Cella D, et al. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2004;22(11):2159–66.
Fleming GF, Filiaci VL, Bentley RC, et al. Phase III randomized trial of doxorubicin + cisplatin versus doxorubicin + 24-h paclitaxel + filgrastim in endometrial carcinoma: a Gynecologic Oncology Group study. Ann Oncol. 2004;15:1173–8.
Miller D, Filiaci V, Fleming G, et al. Randomized phase Ill non-inferiority trial of first line chemotherapy for metastatic or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. Int Gynecol Oncol. 2012;125(3):771.
Ehrlich CE, Young PC, Stehman FB, Sutton GP, Alford WM. Steroid receptors and clinical outcome in patients with adenocarcinoma of the endometrium. Am J Obstet Gynecol. 1988;158(4):796–805.
Thigpen JT, Brady MF, Alvarez RD, et al. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol. 1999;17(6):1736.
Colombo N, Creutzberg C, Amant F, et al. ESMO–ESGO–ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Radiol Oncol. 2015;117(3):559–81.
Thigpen JT, Brady MF, Alvarez RD, et al. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol. 1999;17(6):1736–44.
Whitney CW, Brunetto VL, Zaino RJ, et al. Phase II study of medroxyprogesterone acetate plus tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92(1):4–9.
Thigpen T, Brady MF, Homesley HD, Soper JT, Bell J. Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2001;19(2):364–7.
Scarabelli C, Campagnutta E, Giorda G. Maximal cytoreductive surgery as a reasonable therapeutic alternative for recurrent endometrial carcinoma. Gynecol Oncol. 1998;70:90–3.
Makker V, Green AK, Wenham RM, Mutch D, Davidson B, Miller DS. New therapies for advanced, recurrent, and metastatic endometrial cancers. Gynecol Oncol Res Pract. 2017;4(1):19.
Thigpen JT, Blessing J, Disaia P. Oral medroxy progesterone acetate in advanced or recurrent endometrial carcinoma: results of therapy and correlation with estrogen and progesterone receptor levels. In: Iacobelli S, editor. Endocrinology and malignancy: basic and clinical issues, The proceedings of the first international congress on cancer and hormones. Rome: CRC, Parthenon; 1986. p. 446–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Singhal, S., Kaundal, A. (2020). Recurrent Endometrial Cancer. In: Mehta, S., Gupta, B. (eds) Recent Advances in Endometrial Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-15-5317-2_14
Download citation
DOI: https://doi.org/10.1007/978-981-15-5317-2_14
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-5316-5
Online ISBN: 978-981-15-5317-2
eBook Packages: MedicineMedicine (R0)