title: Analysis of stage IVB endometrial carcinoma patients with distant metastasis: a review of prognoses in 55 patients.
abstract: BACKGROUND
  Adequate treatment for extremely advanced endometrial cancer is unknown. The purpose of this study was to clarify the prognosis of patients with stage IVB endometrial carcinoma and the validity of treatment. Furthermore, we evaluated whether there was a connection between the prognosis and the site of metastasis.
  
  
  METHODS
  The prognoses of 55 patients with stage IVB endometrial carcinoma were studied with reference to the initial treatment method and the metastatic site at the time of the initial treatment.
  
  
  RESULTS
  The median survivals of the group of 35 patients who were initially treated with surgery and the group of 10 patients who underwent radiotherapy or chemotherapy as their initial treatment followed by surgery were 11.5 months and 9.5 months, respectively. The residual tumor diameter after surgery was precisely measured in 40 of these 45 patients. The prognosis was significantly better in the patients with a residual tumor diameter of less than 2 cm compared to those with a tumor diameter of 2 cm or greater, and the median survival periods in these two groups were 23.5 months and 11.5 months, respectively (P = 0.027). Furthermore, the prognosis of patients with lung metastasis was significantly better than that of patients with non-lung hematogenous metastasis; the median survival periods of these two groups were 18.5 months and 10.5 months, respectively (P = 0.014).
  
  
  CONCLUSIONS
  For operable patients, surgery as an initial treatment and reduction of the residual tumor size to less than 2 cm appeared to contribute to a better prognosis. In addition, conservative initial treatment and the presence of non-lung hematogenous metastasis were poor prognostic factors.
authors.affiliation: Department of Gynecology, Kanagawa Cancer Center Hospital, Yokohama, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Numazaki
authors.forename: Etsuko
authors.initials: E
authors.lastname: Miyagi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Konnai
authors.forename: Masae
authors.initials: M
authors.lastname: Ikeda
authors.forename: Akihito
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Onose
authors.forename: Hisamori
authors.initials: H
authors.lastname: Kato
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Okamoto
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
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