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2022-RA-1591-ESGO Major determinants of survival in recurrent endometrial cancer: The role of secondary cytoreductive surgery and relapse pattern. A Multicenter Study
  1. Virginia Vargiu1,
  2. Andrea Rosati2,
  3. Vito Andrea Capozzi3,
  4. Alessandro Gioè2,
  5. Stefano Restaino4,
  6. Aniello Foresta2,
  7. Roberto Berretta3,
  8. Giovanni Scambia2,5,
  9. Francesco Cosentino1,6 and
  10. Francesco Fanfani2,5
  1. 1Department of Oncology, Gemelli Molise SpA, Campobasso, Italy
  2. 2Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  3. 3Department of Medicine and Surgery, University of Parma, Parma, Italy
  4. 4Department of Obstetrics, Gynecology, and Pediatrics, Udine University Hospital, DAME, Udine, Italy
  5. 5Università Cattolica del Sacro Cuore, Rome, Italy
  6. 6Department of Medicine and Health Sciences ‘Vincenzo Tiberio’, Università degli studi del Molise, Campobasso, Italy


Introduction/Background Despite advances in endometrial cancer treatments and knowledge, survival for recurring cancers remains poor.In this study, we evaluated the impact of clinical-histological-radiological variables of patients with endometrial cancer recurrence (ECR) on overall-survival (OS), and specifically, we evaluated the impact of secondary-cytoreductive-surgery (SCS) with the achievement of complete gross resection (CGR) on different types of relapses.

Methodology Multicenter-retrospective analysis of patients with ECR.

Results Three-hundred-thirty-one patients were retrieved. At Cox-regression multivariate analysis, age ≥75 yr (HR: 2.056, p=0.003), advanced prognostic risk-group at initial diagnosis (HR: 3.240, p=0.007) and the presence of multiple site relapses (HR: 1.589, p=0.045) resulted to be statistically significant factors for reduced OS, while SCS and the disease-free survival (time from diagnosis to I relapse) were predictors of improved OS (respectively HR: 0.161, p<0.001, HR: 0.972, p<0.001) (Figure-1).Survival analysis using the Kaplan-Meier method showed that patients with single-site relapse had an improved OS than patients with multiple-site relapses (log-rank p<0.001) (Figure-1).Further stratifying the population on the surgery performed (SCS with CGR vs SCS with residual tumor (RT)> 0 or other secondary treatment), the Kaplan-Meier curves showed that achieving CGR conferred a statistically significant OS benefit for patients with single site metastases (p=0.044) and a trend towards better survival for patients with multiple site metastases (p=0.090) (figure 1).

Abstract 2022-RA-1591-ESGO Figure 1

Conclusion SCS confirmed to be a statistically independent relevant factor for better OS along with DFS in ECR, while age≥75 years, the advanced prognostic risk group and the presence of multiple site relapses were significant factors for decreased OS.In addition, the achievement of CGR conferred a statistically significant survival advantage on patients with single-site recurrence compared to patients not operated or operated with RT>0, while a trend toward better survival could be identified in patients with multiple-site relapses when completely gross resected.

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