Univariate Cox-regression analysis for cause-specific survival after ILR
| Characteristic | No. of events per level of each characteristic | Unadjusted | Adjusted for age at primary surgery | ||
| HR (95% CI) | P value | HR (95% CI) | P value | ||
| Age at primary surgery (years)* | -- | 1.26 (0.96 to 1.67) | 0.10 | – | – |
| Tumor diameter (mm)* | -- | 1.01 (0.79 to 1.28) | 0.97 | 1.06 (0.81 to 1.38) | 0.66 |
| Tumor diameter | 0.62 | 0.35 | |||
| ≤2 cm | 3/5 | Reference | Reference | ||
| >2 cm | 40/57 | 1.45 (0.45 to 4.70) | 1.88 (0.57 to 6.26) | ||
| Unknown | 3/4 | 2.24 (0.45 to 11.17) | 3.37 (0.65 to 17.53) | ||
| Histology | 0.16 | 0.17 | |||
| Endometrioid | 25/41 | Reference | Reference | ||
| Non-endometrioid | 21/25 | 1.52 (0.84 to 2.73) | 1.51 (0.84 to 2.72) | ||
| FIGO stage | 0.27 | 0.11 | |||
| I–II | 9/15 | Reference | Reference | ||
| II–IIV | 37/51 | 1.51 (0.73 to 3.14) | 1.84 (0.87 to 3.90) | ||
| FIGO grade | 0.01 | 0.01 | |||
| 1 | 4/13 | Reference | Reference | ||
| 2–3 | 42/53 | 3.76 (1.34 to 10.54) | 3.61 (1.28 to 10.13) | ||
| LVSI | 0.03 | 0.02 | |||
| No | 16/30 | Reference | Reference | ||
| Yes | 26/31 | 2.37 (1.26 to 4.44) | 2.42 (1.29 to 4.54) | ||
| Unknown | 4/5 | 1.81 (0.61 to 5.42) | 1.40 (0.45 to 4.40) | ||
| Myometrial invasion | 0.29 | 0.30 | |||
| <50% | 16/26 | Reference | Reference | ||
| ≥50% | 30/40 | 1.39 (0.76 to 2.55) | 1.38 (0.75 to 2.54) | ||
| Total number of LNs removed via LND† | -- | 1.00 (0.98 to 1.01) | 0.41 | 1.00 (0.98 to 1.01) | 0.51 |
| Positive LNs via LND | 0.20 | 0.11 | |||
| No LND | 3/6 | Reference | Reference | ||
| LND with negative nodes | 12/19 | 1.73 (0.49 to 6.17) | 1.92 (0.53 to 6.87) | ||
| LND with positive nodes | 31/41 | 2.56 (0.78 to 8.44) | 3.03 (0.91 to 10.10) | ||
| Adjuvant therapy | 0.41 | 0.27 | |||
| Observation±VBT | 12/19 | Reference | Reference | ||
| EBRT±VBT | 14/22 | 0.96 (0.44 to 2.07) | 1.17 (0.53 to 2.57) | ||
| Chemotherapy±VBT | 13/17 | 1.54 (0.70 to 3.40) | 1.79 (0.80 to 4.00) | ||
| Chemotherapy and EBRT±VBT | 6/7 | 1.85 (0.68 to 4.99) | 2.41 (0.85 to 6.77) | ||
| Unknown | 1/1 | – | – | ||
| Site of ILR | 0.21 | 0.26 | |||
| Pelvic | 6/9 | Reference | Reference | ||
| Para-aortic | 8/15 | 0.56 (0.19 to 1.62) | 0.75 (0.24 to 2.37) | ||
| Distant | 13/16 | 0.95 (0.36 to 2.51) | 1.16 (0.42 to 3.19) | ||
| Multiple ILR sites | 19/26 | 1.37 (0.55 to 3.44) | 1.67 (0.63 to 4.41) | ||
| Recurrence details | |||||
| Timing of recurrence following surgery* | -- | 0.94 (0.74 to 1.19) | 0.60 | 0.94 (0.74 to 1.19) | 0.62 |
| LR in an area that was not previously irradiated‡ | 0.84 | 0.92 | |||
| No | 7/11 | Reference | Reference | ||
| Yes | 38/54 | 0.92 (0.41 to 2.06) | 1.04 (0.46 to 2.37) | ||
| Unknown | 1/1 | – | |||
| Treatment of ILR | 0.02 | 0.045 | |||
| Observation or hormonal therapy only | 11/15 | 3.08 (1.24 to 7.67) | 2.74 (1.06 to 7.04) | ||
| Chemotherapy and/or radiotherapy | 27/33 | 2.81 (1.27 to 6.23) | 2.67 (1.20 to 5.95) | ||
| Surgery±other treatments | 8/18 | Reference | Reference | ||
*HR per 10 year increase for age and per doubling for tumor diameter and timing of recurrence following surgery.
†Among those who had the lymphadenectomy; one patient with an unknown number of nodes removed.
‡In the case of multiple sites of ILR, such as pelvic and para-aortic recurrence, all the areas need to be not irradiated to consider the ILR as a recurrence in a non-irradiated area.
EBRT, external beam radiotherapy; FIGO, International Federation of Gynecology and Obstetrics; ILR, isolated lymphatic recurrence; LND, lymphadenectomy; LNs, lymph nodes; LR, lymphatic recurrence; LVSI, lymphovascular space invasion; VBT, vaginal brachytherapy.