title: Patterns of recurrence and outcomes in surgically treated women with endometrial cancer according to ESMO-ESGO-ESTRO Consensus Conference risk groups: Results from the FRANCOGYN study Group.
abstract: OBJECTIVE
  The purpose of this study was to analyse the endometrial cancer (EC) patterns of recurrence based on a large French multicentre database according to ESMO-ESGO-ESTRO classification.
  
  
  METHODS
  Data of women with histologically proven EC who received primary surgical treatment between January 2001 and December 2012 were retrospectively abstracted from seven institutions with prospectively maintained databases. The endpoints were recurrence, recurrence free survival (RFS) and overall survival (OS). Time to the first EC recurrence in a specific site was evaluated by using cumulative incidence analysis (Gray's test).
  
  
  RESULTS
  Data from 829 women were analysed in whom recurrences were observed in 176 (21%) with a median and mean time to recurrence of 13 and 19.5months, respectively. High (35%) and high-intermediate risk groups (16%) were associated with higher recurrence rates compared with low (9%) and intermediate (9%) risk patients (p<0.0001). Women with high risk EC had a higher 5-year cumulative incidence of distant recurrence (20.7%) than women with high-intermediate, intermediate and low risk EC (5.6%, 3.5%, 3.3%), (p<0.001), respectively. Women with high risk and high-intermediate risk EC had a higher 5-year cumulative incidence of loco-regional recurrence (24.3% and 16.6%, respectively) than women with intermediate and low risk EC (6.6% and 6.5%, respectively), (p<0.001).
  
  
  CONCLUSIONS
  We report specific time and site patterns of first recurrence according to the ESMO/ESGO/ESTRO classification. Sites and hazard rates for recurrence differ widely between subgroups over time. Defining patterns of EC recurrence may provide useful information for developing follow-up recommendations and designing therapeutic approaches.
authors: Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR_S_707, "Epidemiology, Information Systems, Modeling", University Pierre and Marie Curie, Paris 6, France. Electronic address: sofiane.bendifallah@aphp.fr.
authors: Sofiane
authors: S
authors: Bendifallah
authors: Department of Obstetrics and Gynaecology, Centre hospitalier régional universitaire de Tours, hôpital Bretonneau, Tours, France.
authors: Lobna
authors: L
authors: Ouldamer
authors: CRLCC Eugène-Marquis, Service de Gynécologie, CHU de Rennes, Université de Rennes 1, France.
authors: Vincent
authors: V
authors: Lavoue
authors: Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France.
authors: Geoffroy
authors: G
authors: Canlorbe
authors: Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
authors: Emilie
authors: E
authors: Raimond
authors: Centre de lutte contre le cancer Georges François Leclerc, Dijon, France.
authors: Charles
authors: C
authors: Coutant
authors: Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
authors: Olivier
authors: O
authors: Graesslin
authors: Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France.
authors: Cyril
authors: C
authors: Touboul
authors: Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France.
authors: Pierre
authors: P
authors: Collinet
authors: Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, France.
authors: Emile
authors: E
authors: Daraï
authors: Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, France.
authors: Marcos
authors: M
authors: Ballester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D010534:Peritoneal Neoplasms / Q000556:secondary*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
keywords: ESMO-ESGO-ESTRO Consensus Conference; Endometrial cancer; Pattern of recurrence