Stage IV endometrial carcinoma: a 10 year review of patients

Stage IV endometrial cancer is uncommon, often occurs in elderly patients a nd has a poor prognosis, which makes the choice of treatment difficult. 18 patients with stage IV endometrial cancer presenting over a 10 year period, between 1987 and 1997, were reviewed with regard to mode of treatment and response. The mean age was 65 years. Five had disease confined to the pelvi s and 13 had extra pelvic disease. 15 of 18 patients had a total abdominal hysterectomy (TAH). One patient received radiotherapy alone and five receiv ed post-operative radiotherapy. Overall freedom from pelvic symptoms was ac hieved in seven of 18 patients. All seven had undergone TAH and two had rec eived post-operative radiotherapy. Progestogens were given to 13 patients. Six received progestogens alone, without radiotherapy or chemotherapy. Of t hese, two responded, one for 9 months and one with verified lung metastases , who had a complete response, is still alive at 6.5 years. Eight patients received chemotherapy, with single agent cisplatin or carboplatin AUC 6. Th ree patients responded, one for 4.5 years. The overall median survival was 12 months from diagnosis. Actuarial 5 year survival was 15% (CI 3-36). Ther e was no significant survival difference for, hormone therapy or chemothera py. Stage IV endometrial cancer has a poor prognosis but durable response c an be achieved in some patients.