Introduction/Background To compare the evolution of patients with recurrence of endometrial cancer according to the diagnosis of recurrence and assess if the diagnosis in the asymptomatic phase has any benefit.
Methodology Retrospective review of 434 endometrial cancer cases between 1996–2017, with follow-up until 2019. We consider asymptomatic when there are no symptoms and recurrence is diagnosed by complementary tests requested during follow-up.
Results There were 71 recurrences (16.4%) with a mean follow-up estimated by Kaplan Meier of 220.1 months (95% confidence interval (CI) 208.0–232.3). In 47 patients was symptomatic (66.2%) and in 24 patients asymptomatic (33.8%). We have not found statistically significant differences in both groups, except in the percentage of positive pelvic nodes, which was higher in the asymptomatic group (5 cases (20.8%) versus 2 cases (4.3%) p=0.04). There were no statistically significant differences in the number of local and distant recurrences (p=0.272). Asymptomatic recurrences in 5 cases (20.83%) were suspected by finding in the physical examination. Therefore, in 52 cases recurrence was suspected due to symptoms or a finding on physical examination (73.2%) and only in 19 cases due to complementary tests requested during follow-up (26.8%). Regarding the time of recurrence, we compared symptomatic and asymptomatic recurrences that occurred in the first 2 years (Hazard ratio (HR) 0.840 (Confidence interval (CI) 95% 0.470–1.502) p=0.557), from 3 to 5 years (HR 0.637 (CI 95% 1.86–2.181) p=0.473) and from 6 to 10 years (HR 0.966(95% CI 0.198–4.711) p=0.966), without finding statistically significant differences. We have compared the overall survival according to the recurrence clinic using Cox regression we have not found differences with an HR 0.964 (95% CI: 0.541–1.717) (p=0.901).
Conclusion Most of the recurrences were diagnosed through a correct clinical history and physical examination. Patients with asymptomatic recurrence did not have a better prognosis than patients with symptomatic recurrence.
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