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2022-RA-1008-ESGO The impact of cytoreductive surgery in FIGO IV and recurrent endometrial cancer
  1. Aleksandra Natalia Strojna1,
  2. Beyhan Ataseven1,2,
  3. Florian Heitz1,3,
  4. Nicole Concin1,
  5. Malak Moubarak1,
  6. Timo Westermann1,
  7. Sabrina Kaiser1,
  8. Nina Pauly1,
  9. Timoleon Dagres1,
  10. Vasileios Vrentas1,
  11. Andreas du Bois1,
  12. Alexander Traut1 and
  13. Philipp Harter1
  1. 1Department of Gynecology and Gynecologic Oncology, Evangelische Kliniken Essen-Mitte, Essen, Germany
  2. 2Department of Obstetrics and Gynecology, University Hospital LMU, Munich, Germany
  3. 3Department for Gynecology with the Center for Oncologic Surgery Charité Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany


Introduction/Background The aim of the study was to assess the oncological outcomes of cytoreductive surgery in FIGO IV and recurrent endometrial cancer.

Methodology This is a retrospective, observational, single-center cohort study including patients with endometrial cancer FIGO IV stage disease undergoing primary cytoreductive surgery and recurrent endometrial cancer treated with secondary cytoreductive surgery between January 1999 and April 2022.

Results 115 patients were included in the present study. In the 53 patients with primary FIGO IV disease complete macroscopic resection was achieved in 42/53 (79.2%) cases. Median OS in these patients was 35 months and median PFS was 15 months. Sixty-two patients had cytoreductive surgery for relapsed endometrial cancer and complete macroscopic resection was achieved in 82.2%. Median OS in this population was 28 months and median PFS was 8.2 months. Patients with complete macroscopic resection showed longer progression-free survival (PFS) and overall survival (OS) compared to those with residual disease (PFS: 15.1 vs 12.9 months; p=0,189; OS: 32.4 vs 17 months; p=0,130). Median OS was 44.6 months (95 % CI 24,6- 64,6 months) in endometrioid subtype (72/115 pts) and 27.4 months (95 %CI 7.2–47.6 months) in other histotypes (p=0.114). Major complications (>Clavien Dindo IIIB) were noted in 10/115 pts (8.7%), mortality rate was 0.9%.

Conclusion Complete macroscopic resection is feasible in selected patients with FIGO IV and relapsed endometrial cancer with an acceptable morbidity, and seemed to be related to superior outcome. However, its impact on prognosis should be further evaluated.

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