[Recurrent endometrial cancer after complete surgery].
Between 1974 and 1991, 576 patients with endometrial cancer were treated with complete surgery. 1. The overall relapse rate was 14.4%. No recurrence was observed in surgical stage Ia, whereas 56.8% relapse was noted in stage IIIc. 2. The relapse rate in cases with adenocarcinoma was 13.0%. The relapse rate increased with poorer differentiation. Five of 6 cases with serous adenocarcinoma developed recurrence. 3. Myometrial invasion, size of tumor, vessel permeation, cervical involvement, adnexal metastasis and lymph node metastasis were significant factors for relapse. 4. Distant recurrence was noted in 63.9% of recurrent cases and 28.9% developed pelvic recurrence. The most common recurrent sites were lung, peritoneal cavity, and para-aortic lymph node in distant relapse and vaginal vault and parametrium in pelvic relapse. 5. The time to relapse ranged between 106 days and 5,518 days after complete surgery. Thirty one point three % of the recurrent cases manifested relapse within the first year, 60.2% within 2 years and 93.9% within 5 years. The mean time to relapse was 561 days. It was concluded that adjuvant therapy for cases with adnexal metastasis, lymph node metastasis, cervical involvement, adenocarcinoma (G3), and serous adenocarcinoma should be established urgently.
Takeshima
N
N
Department of Gynecology, Cancer Institute Hospital, Tokyo.
Umezawa
S
S
Shimizu
Y
Y
Hirai
Y
Y
Chen
J T
JT
Fujimoto
I
I
Yamauchi
K
K
Hasumi
K
K
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000401:mortality / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010386:Pelvic Neoplasms / Q000556:secondary*; D015996:Survival Rate