You are here

Article Text

Article menu
Download PDFPDF
Original research
Endometrial adenocarcinoma recurring in the lung: impact of molecular profile and role of local therapies on prognosis
  1. Ana Luzarraga Aznar1,
  2. Vicente Bebia1,
  3. Carlos López-Gil2,
  4. Alexandra Giraldo3,
  5. MP Montoya4,
  6. Ramona Verges3,
  7. Alberto Jauregui4,
  8. Josep Castellvi5,
  9. Assumpció Pérez-Benavente1,
  10. Eva Colás1,6,
  11. Antonio Gil-Moreno7 and
  12. Silvia Cabrera1,6
  1. 1 Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
  2. 2 Vall d'Hebron Institut de Recerca, Barcelona, Catalunya, Spain
  3. 3 Oncologic Radiotherapy, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
  4. 4 Thoracic Surgery, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
  5. 5 Pathological Anatomy, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
  6. 6 Universitat Autònoma de Barcelona, Barcelona, Spain
  7. 7 Gynecology Department, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
  1. Correspondence to Mr Vicente Bebia, Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Catalunya 08035, Spain; vicente.bebia{at}vallhebron.cat

Abstract

Objectives The objective of our study was to describe the characteristics of patients with endometrial cancer diagnosed with a first recurrence involving the lung, and to describe the prognostic role of the molecular profile. We also aimed to describe the prognostic outcomes after local treatment of recurrence (resection of lung metastases or stereotactic body radiation therapy) in a group of patients with isolated lung recurrence.

Methods This was a retrospective, single-center study between June 1995 and July 2021. The study included patients diagnosed with a first recurrence of endometrial cancer involving the lung. We defined two groups of patients: patients with isolated lung recurrence (confined to the lung) and patients with multisystemic recurrence (in the lung and other locations).

Results Among 1413 patients diagnosed with endometrial cancer in stage IA to IVA of the International Federation of Gynecology and Obstetrics (FIGO) 2009, 64 (4.5%) patients had a first recurrence involving the lung. Of these, 15 (39.1%) were of a non-specific molecular profile, 16 (25%) were p53-abnormal, 15 (23.4%) were mismatch-repair deficient, and 0% POLE-mutated. P53-abnormal patients had the shortest 3 year progression-free survival after recurrence and those with mismatch-repair deficient had the longest 3 year progression-free survival (14.3% (range; 1.6–40.3) and 47.6% (range; 9.1–79.5) respectively, p=0.001). We found no differences on overall survival after recurrence by molecular profile. Thirty-one of 64 (48.4%) patients had an isolated recurrence in the lung, and 16 (25%) patients received local treatment. When comparing patients with isolated lung recurrence, locally treated patients had a longer median progression-free survival than patients treated systemically (41.9 (range, 15.4-NA) vs 7.8 (range, 7.2–10.6) months respectively, p=0.029), a complete response rate of 80% for stereotactic body radiation therapy and a complete resection of 90.9% for surgery.

Conclusion Although few patients will benefit from local treatment (stereotactic body radiation therapy or resection) after a recurrence involving the lung, local therapies might be considered as an option in oligometastatic lung recurrences as they achieve high local control rates and better oncological outcomes than systemic treatment alone.

  • endometrial neoplasms
  • neoplasm metastasis
  • neoplasm recurrence, local
  • radiology, interventional
  • surgical oncology

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/ijgc-2023-004534

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

    View Full Text

    Footnotes

    • Contributors ALA, SC and VB conceived and planned the study. VB performed the statistical analysis. ALA performed the manuscript preparation. SC is the Senior member of the project and supervised the whole study. All authors (AL, VB, CL-G, MPM, AG, RV, AJ, JC, AGM, AP-B, EC) performed a final approval of the version to be published. ALA is responsible for the overall content of the study as the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.