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Location of Disease in Patients Who Die From Endometrial Cancer: A Study of 414 Patients From a Single Institution
  1. Joyce N. Barlin, MD*,
  2. Weiya Z. Wysham, MD*,
  3. Aaron M. Ferda, MD*,
  4. Fady Khoury-Collado, MD*,
  5. Danielle K. Cassella, MA*,
  6. Kaled M. Alektiar, MD,
  7. Martee L. Hensley, MD,
  8. Dennis S. Chi, MD*,
  9. Richard R. Barakat, MD* and
  10. Nadeem R. Abu-Rustum, MD*
  1. *Department of Surgery, Gynecology Service;
  2. Department of Radiation Oncology, Brachytherapy Service; and
  3. Department of Medicine, Gynecologic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY.
  1. Address correspondence and reprint requests to Nadeem R. Abu-Rustum, MD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 261, New York, NY 10065. E-mail: gynbreast@mskcc.org.

Abstract

Objective The purpose of this study was to describe the location of disease at the time of death of patients with endometrial cancer who died of their disease.

Methods All patients with a diagnosis of endometrial cancer from January 1993 through December 2010 were included. Histologic classification was either endometrioid or high-risk (HR) endometrial cancer. Patients who died were divided into 3 groups: dead of disease (DOD), dead of other causes (DOO), and dead lost to follow-up. Patterns of disease spread at death were documented from the most recent examination and imaging studies.

Results We identified 2513 patients. The median age at diagnosis was 62 years. Histologic findings were endometrioid endometrial cancer, 1949 patients (78%); and HR endometrial cancer, 54 patients (22%). The 1988 International Federation of Gynecology and Obstetrics stages were: stage I, 1763 patients (70%); stage II, 145 patients (6%); stage III, 416 patients (17%); and stage IV, 189 patients (8%). At the time of this study, 1867 patients (74%) had no evidence of disease, 232 patients (9%) were alive with disease, and 414 patients (16%) were dead. Of the 16% of patients who were dead, 224 (9%) of the 2513 patients were DOD, 84 (3%) of the 2513 patients were dead of other disease, and 106 (4%) of the 2513 patients were dead lost to follow-up. Of the 224 patients who were DOD, the locations of the disease at the time of death were pelvic, 23 patients (10%); abdominal, 83 patients (37%); and distant, 118 patients (53%). There was no significant difference in the pattern of location of disease between the endometrioid and HR histologies (P = 0.36).

Conclusions These data suggest that death from endometrial cancer is largely due to abdominal (liver) and distant (lung) metastases, and this pattern of disease seems similar in the endometrioid and HR histologies. Most of the patients who died of their disease had metastases beyond the pelvis at the time of death.

  • Endometrial cancer
  • Mortality
  • Location of disease

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Footnotes

  • The authors declare no conflicts of interest.

  • Poster presentation at the 43rd Annual Meeting of the Society of Gynecologic Oncology, Austin, Texas, March 2012.

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