PT  - JOURNAL ARTICLE
AU  - Bricou, Alexandre
AU  - Bendifallah, Sofiane
AU  - Daix-Moreux, Mathilde
AU  - Ouldamer, Lobna
AU  - Lavoue, Vincent
AU  - Benbara, Amélie
AU  - Huchon, Cyrille
AU  - Canlorbe, Geoffroy
AU  - Raimond, Emilie
AU  - Coutant, Charles
AU  - Graesslin, Olivier
AU  - Collinet, Pierre
AU  - Carcopino, Xavier
AU  - Touboul, Cyril
AU  - Daraï, Emile
AU  - Carbillon, Lionel
AU  - Ballester, Marcos
TI  - A Proposal for a Classification for Recurrent Endometrial Cancer: Analysis of a French Multicenter Database From the FRANCOGYN Study Group
AID  - 10.1097/IGC.0000000000001296
DP  - 2018 Sep 01
TA  - International Journal of Gynecologic Cancer
PG  - 1278--1284
VI  - 28
IP  - 7
4099  - http://ijgc.bmj.com/content/28/7/1278.short
4100  - http://ijgc.bmj.com/content/28/7/1278.full
SO  - Int J Gynecol Cancer2018 Sep 01; 28
AB  - Objective Endometrial cancer (EC) recurrences are relatively common with no standardized way of describing them. We propose a new classification for them called locoregional, nodal, metastasis, carcinomatosis recurrences (rLMNC).Patients and Methods The data of 1230 women with EC who were initially treated by primary surgery were included in this French multicenter retrospective study. Recurrences were classified based on dissemination pathways: (1) locoregional recurrence (rL); (2) nodal recurrence (rN) for lymphatic pathway; (3) distant organ recurrence (rM) for hematogenous pathway; and (4) carcinomatosis recurrence (rC) for peritoneal pathway. These pathways were further divided into subgroups. We compared recurrence free survival and overall survival (OS) between the 4 groups (rL/rN/rM/rC).Results The median follow-up was 35.6 months (range, 1.70–167.60). One hundred ninety-eight women (18.2%) experienced a recurrence: 150 (75.8%) experienced a single-pathway recurrence and 48 (24.2%) a multiple-pathway recurrence. The 5-year OS was 34.1% (95% confidence interval [CI], 27.02%–43.1%), and the median time to first recurrence was 18.9 months (range, 0–152 months). The median survival after recurrence was 14.8 months (95% CI, 11.7–18.8). Among women with single pathway of recurrence, a difference in 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) was found between the 4 rLNMC groups. The carcinomatosis group had the worst prognosis compared with other single recurrence pathways. Women with multiple recurrences had poorer 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) than those with single metastasis recurrence, other than women with peritoneal carcinomatosis.Conclusions This easy-to-use and intuitive classification may be helpful to define EC recurrence risk groups and develop guidelines for the management of recurrence. Its prognosis value could also be a tool to select homogenous populations for further trials.