Introduction/Background Endometrial cancer comprises heterogeneous subgroups with varying outcomes. This study assessed disease characteristics and survival outcomes in patients with recurrent/de novo metastatic endometrial cancer.

Methodology Patients diagnosed with recurrent or de novo metastatic endometrial cancer between 2012–2015 in BC, Canada, were included. Disease characteristics and treatments were summarized with descriptive statistics. Median overall survival (mOS) was assessed using univariable and multivariable analyses. Survival analysis was estimated with the Kaplan-Meier method.

Results Of 188 patients, 97 had recurrent disease and 91 had de novo metastatic disease. Median age was 65 (range 36–93). 73 patients (39%) received one line of palliative systemic therapy, 26 (14%) received 2 lines, 26 (14%) received 3 lines, and 12 (6%) received ≥4 lines. 51 patients (27%) received no systemic therapy, but had definitive salvage treatment for locally recurrent disease. mOS from time of metastasis was similar between patients with de novo or recurrent metastatic disease (16.2 vs 15.6m, p=0.43). Patients with isolated relapses in the vagina (67.3m) and pelvis (83.6m) had longer OS than those with other recurrences (p=0.00013). mOS was similar between those who received first-line palliative systemic therapy vs those who did not (17.1 vs. 15.6m, p=0.11); however, 35% of patients with no palliative systemic therapy continued to survival beyond 5 years, mostly due to salvage therapy for locally recurrent disease. mOS was longer in those treated with 1st line aromatase inhibitors or tamoxifen than with platinum doublet therapy (30.1 vs. 13.9m, p=0.041). Patients who underwent ≥4 lines of therapy had longer mOS outcomes compared to ≤3 lines of therapy (HR 0.349, 95%CI 0.127–0.962, p=0.042).

Conclusion Those with recurrent/metastatic disease amenable to local salvage therapy or palliative hormone agents have prolonged OS. A select number of patients underwent multiple lines of treatment, with extended survival. Future studies should examine outcomes with immunotherapy.

Disclosures None.