Lobna Ouldamer1, Sofiane Bendifallah2, Gilles Body3, Cyril Touboul4, Olivier Graesslin5, Emilie Raimond5, Pierre Collinet6, Charles Coutant7, Alexandre Bricou8, Vincent Lavoué9, Jean Lévêque9, Emile Daraï10, Marcos Ballester10. 1. Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France; INSERM U1069 Université François-Rabelais, Tours, France. Electronic address: l.ouldamer@chu-tours.fr. 2. Department of Gynecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; UMR_S938 Sorbonne University, Paris, France. 3. Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France; INSERM U1069 Université François-Rabelais, Tours, France. 4. Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France. 5. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France. 6. Department of Gynecological Surgery, Jeanne de Flandre University Hospital, Lille, France. 7. Centre de lutte contre le cancer Georges François Leclerc, Dijon, France. 8. Department of Gynaecology, Bobigny University, AP-HP, Hôpital Jean-Verdier, Bondy, France. 9. Department of Gynecological Surgery, Rennes University Hospital, Rennes, France. 10. Department of Gynecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France; INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France.
Abstract
Patterns of distant metastatic failure of endometrial cancer (EC) by specific anatomic site are not well described in the literature. In this manuscript, we evaluated the metastatic patterns of EC cancer and analysed the potential distribution of metastatic disease in this malignancy. METHODS: A total of 1444 women with EC were identified. Of which we extracted women with locoregional and distant recurrence or with distant recurrence alone. Women were scored based on first site of metastasis: multiple versus one site: bone, brain, lung, liver or sus diaphragmatic lymph nodes. RESULTS: 110 women developed distant metastatic disease with (n = 37(33.6%)) or without (n = 73(66.4%)) locoregional recurrence, including 39 women with exclusive first site of metastatic disease and 34 women with multiple sites of metastatic disease. When considering all women, the most common exclusive first site of metastasis was lung (42.8%). The median time to develop distant metastases was shorter after the completion of treatment for exclusive brain metastatic disease compared with other sites of metastatic- disease (7 months vs, 9 for lung, 10 for liver, 19 for bone and 27 months for sus-diaphragmatic LN; P = 0.004). The rate of 3-year overall survival was higher in the sus-diaphragmatic LN metastase group (83.3% vs 50.6% for lung, 37.3% for bone, 16.7% for brain and 0% for liver; P = 0.0059). CONCLUSION: The present study has demonstrated the site-specific patterns of metastases. These data support current clinical practice of screening for site-specific metastatic disease after initial treatment of early stage EC based on concerning women-specific signs or symptoms.
Patterns of distant metastatic failure of endometrial cancer (EC) by specific anatomic site are not well described in the literature. In this manuscript, we evaluated the metastatic patterns of EC cancer and analysed the potential distribution of metastatic disease in this malignancy. METHODS: A total of 1444 women with EC were identified. Of which we extracted women with locoregional and distant recurrence or with distant recurrence alone. Women were scored based on first site of metastasis: multiple versus one site: bone, brain, lung, liver or sus diaphragmatic lymph nodes. RESULTS: 110 women developed distant metastatic disease with (n = 37(33.6%)) or without (n = 73(66.4%)) locoregional recurrence, including 39 women with exclusive first site of metastatic disease and 34 women with multiple sites of metastatic disease. When considering all women, the most common exclusive first site of metastasis was lung (42.8%). The median time to develop distant metastases was shorter after the completion of treatment for exclusive brain metastatic disease compared with other sites of metastatic- disease (7 months vs, 9 for lung, 10 for liver, 19 for bone and 27 months for sus-diaphragmatic LN; P = 0.004). The rate of 3-year overall survival was higher in the sus-diaphragmatic LN metastase group (83.3% vs 50.6% for lung, 37.3% for bone, 16.7% for brain and 0% for liver; P = 0.0059). CONCLUSION: The present study has demonstrated the site-specific patterns of metastases. These data support current clinical practice of screening for site-specific metastatic disease after initial treatment of early stage EC based on concerning women-specific signs or symptoms.