TY - JOUR T1 - A Proposal for a Classification for Recurrent Endometrial Cancer: Analysis of a French Multicenter Database From the FRANCOGYN Study Group JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1278 LP - 1284 DO - 10.1097/IGC.0000000000001296 VL - 28 IS - 7 AU - Alexandre Bricou AU - Sofiane Bendifallah AU - Mathilde Daix-Moreux AU - Lobna Ouldamer AU - Vincent Lavoue AU - Amélie Benbara AU - Cyrille Huchon AU - Geoffroy Canlorbe AU - Emilie Raimond AU - Charles Coutant AU - Olivier Graesslin AU - Pierre Collinet AU - Xavier Carcopino AU - Cyril Touboul AU - Emile Daraï AU - Lionel Carbillon AU - Marcos Ballester Y1 - 2018/09/01 UR - http://ijgc.bmj.com/content/28/7/1278.abstract N2 - 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. ER -