title: Endometrial carcinoma: better prognosis for asymptomatic recurrences than for symptomatic cases found by routine follow-up.
abstract: BACKGROUND
  The aim of this study was to determine if there is a prognostic value for the presence of symptoms at the time of recurrence detection in surgically resected endometrial carcinoma patients.
  
  
  METHODS
  During the study period of 2000-2006, complete surgical removal of endometrial carcinoma was achieved in 271 stage I-IV endometrial cancer cases at the Department of Obstetrics and Gynecology of Osaka University Hospital, Osaka, Japan. A subsequent recurrence was detected in 29 (11%) of these cases. Patient characteristics and clinicopathological features were retrospectively reviewed utilizing their clinical records.
  
  
  RESULTS
  Among the 29 cases with a recurrence, 13 (45%) had symptoms, whereas in the other 16 cases (55%) the recurrent disease was found only during routine follow-up procedures. Although the time to detection of recurrence was similar for both asymptomatic and symptomatic cases, progression-free survival after detection in the 16 asymptomatic patients was significantly longer than for the 13 symptomatic patients (P = 0.017); this was found to be especially true in those who underwent chemotherapy as their adjuvant therapy (P = 0.023).
  
  
  CONCLUSIONS
  A better prognosis after recurrence was demonstrated in cases that were asymptomatic at the time of recurrence detection than in those in which the tumor was symptomatic. This finding implies that, after the initial surgical resection, intensive follow-up intervention looking for asymptomatic recurrences may significantly improve the prognosis of endometrial carcinoma patients. A further in-depth prospective study is required to establish a standard strategy of follow-up care for endometrial cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Tomomi
authors.initials: T
authors.lastname: Egawa-Takata
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyatake
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuzaki
authors.forename: Takuhei
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Yukari
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D018269:Carcinoma, Endometrioid / Q000150:complications / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome