Isolated peripheral lymph node recurrence of endometrial carcinoma.

The natural history of endometrial carcinoma recurring first in an inguinal, axillary, or supraclavicular node as an isolated site is not well documented. Twenty-two patients with such a recurrence were examined between January 1963 and December 1986 at our institution. This event is associated with a higher initial surgical stage and tumor grade. Supraclavicular and inguinal recurrences occur with equal frequency. Axillary recurrences are rare. Overall, 15 patients achieved local control of the nodal recurrence, including all seven patients treated by excision and aggressive local irradiation. Of the seven patients with uncontrolled local disease, four experienced significant local morbidity. Initial supraclavicular recurrence seems to be associated with subsequent systemic progression, whereas initial inguinal recurrence seems to be associated with subsequent abdominal progression. Although the median survival after isolated peripheral lymph node recurrence is only 19 months, six patients are alive without evidence of cancer at a median follow-up of 27 months. Although an effective systemic adjuvant treatment for these patients is needed, aggressive local treatment after thorough restaging can provide long-term, disease-free survival.