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        Factors associated with survival after relapse in patients with low-risk endometrial cancer treated with surgery alone

        Nazli Topfedaisi Ozkan,Mehmet Mutlu Meydanlı,Mustafa Erkan Sarı,Fuat Demirkiran,Ilker Kahramanoglu,TUGAN BESE,Macit Arvas,Hanifi Şahin,Ali Haberal,Husnu Celik,Gonca Coban,Tufan Oge,Omer Tarik Yalcin,Ö 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

        Objective: To determine factors influencing overall survival following recurrence (OSFR) inwomen with low-risk endometrial cancer (EC) treated with surgery alone. Methods: A multicenter, retrospective department database review was performed to identifypatients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion[MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected. Results: We identified 67 patients who developed recurrence of their EC after initially beingdiagnosed and treated for low-risk EC. For the entire study cohort, the median time torecurrence (TTR) was 23 months (95% confidence interval [CI]=11.5–34.5; standard error[SE]=5.8) and the median OSFR was 59 months (95% CI=12.7–105.2; SE=23.5). We observed32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were locoregionalwhereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group(GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as highintermediaterisk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65–43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69–12.58; p=0.003) weresignificant predictors. Conclusion: Low-risk EC patients recurring earlier than 36 months and those carrying HIRcriteria seem more likely to succumb to their tumors after recurrence.

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