Introduction/Background Endometrial carcinoma is the most common gynecologic malignancy in high-income countries and the fourth most common cancer in females.

The vast majority of patients are diagnosed with early-stage disease (when disease is still confined to the uterus) and thus have a high survival rate.

Despite this and although the risk of locoregional recurrence is low, 7 to 15% of patients in early stage (I-II) present recurrent disease (locoregional recurrence, distant metastasis or both). Patients with advanced-stage disease at diagnosis or with a more aggressive subtype have a higher probability of both locoregional and distant recurrence. The treatment of recurrent endometrial cancer represents a major challenge.

Methodology This is a retrospective cohort study from 2018 to 2023 including all women with endometrial cancer treated at IPO-C (Portuguese Institute of Oncology of Coimbra).

Results During the study period, 214 patients were diagnosed with endometrial cancer. Among these, 142 patients (66.3%) had low stage disease (FIGO-stage I).

The recurrence rate was 12,6% (27 patients) and the median time of recurrence was 1,46 years.

About 44,4% of the patients with a recurrence have locoregional disease, 37% present with distant recurrence and the remaining 18,6% have both.

In patients who recurred, the prevalence of endometrioid carcinomas was significantly higher compared to other types (serous, undifferentiated and sarcomas).

The recurrence rate was lower in patients with low FIGO-stage versus patients with high FIGO-stage.

Conclusion There is a need for more effective therapies in the context of recurrent endometrial disease as well as mechanisms for early identification of cancer diagnosis and recurrence. The focus in multimodal adjuvant therapy has been to evaluate the inclusion of systemic therapy to reduce distant recurrence and radiotherapy to reduce locoregional recurrence

Disclosures The authors declare that they have no conflict of interest.