RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP 1278
OP 1284
DO 10.1097/IGC.0000000000001296
VO 28
IS 7
A1 Bricou, Alexandre
A1 Bendifallah, Sofiane
A1 Daix-Moreux, Mathilde
A1 Ouldamer, Lobna
A1 Lavoue, Vincent
A1 Benbara, Amélie
A1 Huchon, Cyrille
A1 Canlorbe, Geoffroy
A1 Raimond, Emilie
A1 Coutant, Charles
A1 Graesslin, Olivier
A1 Collinet, Pierre
A1 Carcopino, Xavier
A1 Touboul, Cyril
A1 Daraï, Emile
A1 Carbillon, Lionel
A1 Ballester, Marcos
YR 2018
UL http://ijgc.bmj.com/content/28/7/1278.abstract
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.