Is time to recurrence after hysterectomy predictive of survival in patients with early stage endometrial carcinoma?

Jared R. Robbins, Raphael Yechieli, Benjamin Laser, Meredith Mahan, Nabila Rasool, Mohamed A. Elshaikh

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose/objective(s): To determine the prognostic significance of time to recurrence (TTR) on overall survival (OS) and disease-specific survival (DSS) following recurrence in patients with stage I-II uterine endometrioid carcinoma. Materials/methods: After IRB approval, we retrospectively identified 57 patients with recurrent endometrioid carcinoma who were initially treated for FIGO 1988 stages I-II between 1987 and 2009. The Kaplan-Meier approach and Cox regression analysis were used to estimate OS and DSS following recurrence and identify factors impacting outcomes. Results: Median follow-up times were 54.8 months from hysterectomy and 19.8 months after recurrence. Median time to recurrence was 20.2 months. Twenty-eight (47%) patients had a recurrence < 18 months after hysterectomy and 29 (53%) had a recurrence ≥ 18 months. Both groups were evenly matched regarding initial pathological features and adjuvant treatments. The median OS and DSS in patients with TTR < 18 months was shorter than those with TTR ≥ 18 months, but not statistically significant (p = 0.216). TTR did not impact outcomes after loco-regional recurrence, but for extrapelvic recurrence, a shorter TTR resulted in worse OS and DSS (p = 0.03). On multivariate analysis, isolated loco-regional recurrence (HR 0.28, p = 0.001) and salvage radiation therapy (HR 0.47, p = 0.045) were statistically significant independent predictors of longer OS following recurrence. TTR as a continuous variable or dichotomized was not predictive of OS or DSS. Conclusions: In our study, the prognostic impact of time to recurrence was less important than the site of recurrence. While not prognostic for the entire cohort or for patients with loco-regional recurrence, TTR < 18 months was associated with shorter OS and DSS after extrapelvic recurrence.

Original languageEnglish (US)
Pages (from-to)38-42
Number of pages5
JournalGynecologic Oncology
Volume127
Issue number1
DOIs
StatePublished - Oct 2012
Externally publishedYes

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Endometrial Neoplasms
Hysterectomy
Recurrence
Survival
Endometrioid Carcinoma
Salvage Therapy
Research Ethics Committees

Keywords

  • Endometrial carcinoma
  • Prognosis
  • Recurrence
  • Time to recurrence
  • Uterine neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Is time to recurrence after hysterectomy predictive of survival in patients with early stage endometrial carcinoma? / Robbins, Jared R.; Yechieli, Raphael; Laser, Benjamin; Mahan, Meredith; Rasool, Nabila; Elshaikh, Mohamed A.

In: Gynecologic Oncology, Vol. 127, No. 1, 10.2012, p. 38-42.

Research output: Contribution to journalArticle

Robbins, Jared R. ; Yechieli, Raphael ; Laser, Benjamin ; Mahan, Meredith ; Rasool, Nabila ; Elshaikh, Mohamed A. / Is time to recurrence after hysterectomy predictive of survival in patients with early stage endometrial carcinoma?. In: Gynecologic Oncology. 2012 ; Vol. 127, No. 1. pp. 38-42.
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abstract = "Purpose/objective(s): To determine the prognostic significance of time to recurrence (TTR) on overall survival (OS) and disease-specific survival (DSS) following recurrence in patients with stage I-II uterine endometrioid carcinoma. Materials/methods: After IRB approval, we retrospectively identified 57 patients with recurrent endometrioid carcinoma who were initially treated for FIGO 1988 stages I-II between 1987 and 2009. The Kaplan-Meier approach and Cox regression analysis were used to estimate OS and DSS following recurrence and identify factors impacting outcomes. Results: Median follow-up times were 54.8 months from hysterectomy and 19.8 months after recurrence. Median time to recurrence was 20.2 months. Twenty-eight (47{\%}) patients had a recurrence < 18 months after hysterectomy and 29 (53{\%}) had a recurrence ≥ 18 months. Both groups were evenly matched regarding initial pathological features and adjuvant treatments. The median OS and DSS in patients with TTR < 18 months was shorter than those with TTR ≥ 18 months, but not statistically significant (p = 0.216). TTR did not impact outcomes after loco-regional recurrence, but for extrapelvic recurrence, a shorter TTR resulted in worse OS and DSS (p = 0.03). On multivariate analysis, isolated loco-regional recurrence (HR 0.28, p = 0.001) and salvage radiation therapy (HR 0.47, p = 0.045) were statistically significant independent predictors of longer OS following recurrence. TTR as a continuous variable or dichotomized was not predictive of OS or DSS. Conclusions: In our study, the prognostic impact of time to recurrence was less important than the site of recurrence. While not prognostic for the entire cohort or for patients with loco-regional recurrence, TTR < 18 months was associated with shorter OS and DSS after extrapelvic recurrence.",
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AU - Elshaikh, Mohamed A.

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AB - Purpose/objective(s): To determine the prognostic significance of time to recurrence (TTR) on overall survival (OS) and disease-specific survival (DSS) following recurrence in patients with stage I-II uterine endometrioid carcinoma. Materials/methods: After IRB approval, we retrospectively identified 57 patients with recurrent endometrioid carcinoma who were initially treated for FIGO 1988 stages I-II between 1987 and 2009. The Kaplan-Meier approach and Cox regression analysis were used to estimate OS and DSS following recurrence and identify factors impacting outcomes. Results: Median follow-up times were 54.8 months from hysterectomy and 19.8 months after recurrence. Median time to recurrence was 20.2 months. Twenty-eight (47%) patients had a recurrence < 18 months after hysterectomy and 29 (53%) had a recurrence ≥ 18 months. Both groups were evenly matched regarding initial pathological features and adjuvant treatments. The median OS and DSS in patients with TTR < 18 months was shorter than those with TTR ≥ 18 months, but not statistically significant (p = 0.216). TTR did not impact outcomes after loco-regional recurrence, but for extrapelvic recurrence, a shorter TTR resulted in worse OS and DSS (p = 0.03). On multivariate analysis, isolated loco-regional recurrence (HR 0.28, p = 0.001) and salvage radiation therapy (HR 0.47, p = 0.045) were statistically significant independent predictors of longer OS following recurrence. TTR as a continuous variable or dichotomized was not predictive of OS or DSS. Conclusions: In our study, the prognostic impact of time to recurrence was less important than the site of recurrence. While not prognostic for the entire cohort or for patients with loco-regional recurrence, TTR < 18 months was associated with shorter OS and DSS after extrapelvic recurrence.

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