Introduction/Background This study was aimed to evaluate the impact of complete surgical resection of recurrent tumor on the long-term survival of patients with endometrioid type endometrial cancer.
Methodology Medical records of patients diagnosed with endometrioid endometrial cancer between 2009 and 2019 at six different hospitals were reviewed. Eligible criteria included patients who underwent appropriate primary treatment including hysterectomy and surgical staging according to practice guidelines, had no radiologic evidence of residual disease after completion of primary treatment, and experienced recurrence. Patients with insufficient data for survival analyses were excluded. Time to second objective disease progression (PFS2) and second-line overall survival (OS2) were analyzed using the Kaplan-Meier method and compared using the log-rank test. The prognostic significance was assessed using the Cox regression hazards model. Patients were followed up for a median of 43.0 months (95% CI 40.7–58.3) after their first recurrence.
Results A total of 75 patients meeting the eligible criteria were included in the survival analysis. The median PFS2 was significantly longer in patients who underwent complete surgical resection compared to those who did not (34.0 vs. 10.0 months, log-rank P < 0.001). Multivariable analysis showed that complete surgical resection was associated with favorable PFS2 (adjusted HR, 0.46; 95% CI, 0.22–0.94; adjusted P = 0.033). However, the median OS2 was not significantly different between the two groups (not reached vs. 40.0 months, log-rank P = 0.062). Multivariable analysis revealed that presence of peritoneal recurrence was the only factor associated with OS2 (HR, 2.31; 95% CI, 1.12–4.74; adjusted P = 0.023).
Conclusion Our study suggests that complete surgical resection for recurrent endometrioid endometrial cancer may delay the time from the first to second recurrence; however, it does not appear to improve OS2. The presence of peritoneal recurrence was associated with worse OS2.
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