Results of radical radiotherapy for recurrent endometrial cancer

Objectives, The aims of this study were to determine the overall survival ( OS) and local control (LC) achieved in patients developing a locoregional r ecurrence of endometrial carcinoma and to define those prognostic factors t hat predict for improved LC and OS, Methods. Between 1984 and 1988, 958 women were referred to Princess Margare t Hospital (PMH) with a diagnosis of endometrial carcinoma. Of these, 58 we re treated for recurrent disease with radical radiotherapy (RT), Forty-two were referred with recurrence and 16 relapsed during follow-up at PMH for t heir primary tumor. None had received prior RT. The majority (n = 49) were treated with combined external beam RT followed by an intracavitary cesium insertion. Results. The median time to relapse from original diagnosis was 1.3 years ( range 0.2-13.4 years). The actuarial 5- and 10-year OS was 53 and 41%, resp ectively. The respective results for LC were 65 and 62%. All end-points wer e measured from the time of relapse. The median total dose received was 81. 5 Gy. Univariate analysis showed that favorable histological features at or iginal diagnosis (<50% myometrial involvement, grade 1-2, P = 0.007) and Pe rez modified staging (P = 0.02) were significant predictors for OS. The Per ez staging (P = 0.02) and size of recurrence (<2 cm versus greater than or equal to 2 cm, P = 0.04) were predictors for LC, Conclusion. Patients with localized relapse of endometrial carcinoma in who m radical radiotherapy can be administered should be treated aggressively a nd may be cured in over half the eases treated. Pathological findings in th e original surgical specimen, size of recurrent disease, and a modified vag inal carcinoma staging system are significant predictors of local pelvic co ntrol and survival. (C) 2000 Academic Press.