Prognostic significance of the treatment-free interval in patients with recurrent endometrial cancer.
OBJECTIVE
To identify prognostic factors of recurrent endometrial cancer, and clarify whether the treatment-free interval (TFI) predicts outcome in a wide spectrum of patients.


METHODS
The clinical data of 60 patients treated for recurrent stage I-IV endometrial cancer between 1997 and 2012 were reviewed retrospectively. The Kaplan-Meier method and Cox regression analysis were used to estimate overall survival (OS) following recurrence and determine the factors influencing outcomes.


RESULTS
The median age at initial treatment was 59 (range 38-80) years and the median post-recurrence overall survival time was 40.0 (range 1.8-156.7) months. Multivariate analysis showed lymph node metastasis (hazard ratio (HR) 2.80; 95% confidence interval (95%CI) 1.29-6.09; p=0.009), TFI (HR 0.33; 95% CI 0.15-0.76; p=0.008), and symptomatic recurrence (HR 2.31, 95% CI 1.11-4.83, p=0.0025) were independent prognostic factors. Patients whose tumors recurred after a TFI≥12 months had better response rates than did those with a TFI<12 months (p<0.001).


CONCLUSIONS
TFI is a significant prognostic factor in recurrent endometrial cancer. Furthermore, the effect of chemotherapy on recurrent endometrial cancer is probably influenced by the duration of TFI.
Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan.
Kumi
K
Shimamoto
Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan. Electronic address: tsaitou@nk-cc.go.jp.
Toshiaki
T
Saito
Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan.
Masao
M
Okadome
Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan.
Mototsugu
M
Shimokawa
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors
Effect of chemotherapy; Prognostic factors; Recurrent endometrial cancer; Treatment-free interval