Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery

Edward Podczaski, Paul Kaminski, Karen Gurski, Colin MacNeill, John A. Stryker, Kishor Singapuri, Thomas E. Hackett, Joel Sorosky, Richard Zaino

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

From November 1977 to July 1987, 300 consecutive patients with endometrial carcinoma clinically confined to the uterine corpus underwent primary surgery consisting of at least abdominal hysterectomy and adnexectomy. Patients with aggressive disease characteristics received postoperative radiotherapy. Forty-seven patients (16%) demonstrated recurrent disease from 2 to 125 (median of 12.8) months after surgery. Forty-seven percent of the recurrences were detected within the first year following surgery and 70% by 2 years after hysterectomy. Of the 47 recurrences, 29 were at distant sites, 16 were within the pelvis, and 2 consisted of both local and distant recurrences. Patients treated with pelvic radiotherapy after hysterectomy were more likely to experience distant, rather than local recurrences. Only 7 of the 148 patients (5%) treated with postoperative radiotherapy recurred in the pelvis. Approximately half of the recurrences were detected in asymptomatic individuals; physical examination and chest X-ray were the most useful means to detect disease in patients without symptoms. The combination of history, physical examination, pap smear, and chest X ray detected all of the recurrences. Actuarial survivals at 12, 24, and 36 months after recurrence were 42, 24, and 17%, respectively. The site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis. The identification of patients at risk of recurrence and more effective adjuvant therapy need to be developed in order to decrease the frequency of recurrence. In order to substantially improve the survival of patients with recurrent disease, more sensitive methods of detection, as well as more effective salvage therapy, will be required.

Original languageEnglish (US)
Pages (from-to)323-327
Number of pages5
JournalGynecologic Oncology
Volume47
Issue number3
DOIs
StatePublished - Dec 1992

Fingerprint

Endometrial Neoplasms
Treatment Failure
Recurrence
Radiotherapy
Hysterectomy
Pelvis
Physical Examination
Thorax
X-Rays
Papanicolaou Test
Salvage Therapy
Survival
History

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Podczaski, Edward ; Kaminski, Paul ; Gurski, Karen ; MacNeill, Colin ; Stryker, John A. ; Singapuri, Kishor ; Hackett, Thomas E. ; Sorosky, Joel ; Zaino, Richard. / Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery. In: Gynecologic Oncology. 1992 ; Vol. 47, No. 3. pp. 323-327.
@article{d4e2ca2a112f42579c5d29e9f9678388,
title = "Detection and patterns of treatment failure in 300 consecutive cases of {"}early{"} endometrial cancer after primary surgery",
abstract = "From November 1977 to July 1987, 300 consecutive patients with endometrial carcinoma clinically confined to the uterine corpus underwent primary surgery consisting of at least abdominal hysterectomy and adnexectomy. Patients with aggressive disease characteristics received postoperative radiotherapy. Forty-seven patients (16{\%}) demonstrated recurrent disease from 2 to 125 (median of 12.8) months after surgery. Forty-seven percent of the recurrences were detected within the first year following surgery and 70{\%} by 2 years after hysterectomy. Of the 47 recurrences, 29 were at distant sites, 16 were within the pelvis, and 2 consisted of both local and distant recurrences. Patients treated with pelvic radiotherapy after hysterectomy were more likely to experience distant, rather than local recurrences. Only 7 of the 148 patients (5{\%}) treated with postoperative radiotherapy recurred in the pelvis. Approximately half of the recurrences were detected in asymptomatic individuals; physical examination and chest X-ray were the most useful means to detect disease in patients without symptoms. The combination of history, physical examination, pap smear, and chest X ray detected all of the recurrences. Actuarial survivals at 12, 24, and 36 months after recurrence were 42, 24, and 17{\%}, respectively. The site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis. The identification of patients at risk of recurrence and more effective adjuvant therapy need to be developed in order to decrease the frequency of recurrence. In order to substantially improve the survival of patients with recurrent disease, more sensitive methods of detection, as well as more effective salvage therapy, will be required.",
author = "Edward Podczaski and Paul Kaminski and Karen Gurski and Colin MacNeill and Stryker, {John A.} and Kishor Singapuri and Hackett, {Thomas E.} and Joel Sorosky and Richard Zaino",
year = "1992",
month = "12",
doi = "10.1016/0090-8258(92)90134-5",
language = "English (US)",
volume = "47",
pages = "323--327",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "3",

}

Podczaski, E, Kaminski, P, Gurski, K, MacNeill, C, Stryker, JA, Singapuri, K, Hackett, TE, Sorosky, J & Zaino, R 1992, 'Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery', Gynecologic Oncology, vol. 47, no. 3, pp. 323-327. https://doi.org/10.1016/0090-8258(92)90134-5

Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery. / Podczaski, Edward; Kaminski, Paul; Gurski, Karen; MacNeill, Colin; Stryker, John A.; Singapuri, Kishor; Hackett, Thomas E.; Sorosky, Joel; Zaino, Richard.

In: Gynecologic Oncology, Vol. 47, No. 3, 12.1992, p. 323-327.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery

AU - Podczaski, Edward

AU - Kaminski, Paul

AU - Gurski, Karen

AU - MacNeill, Colin

AU - Stryker, John A.

AU - Singapuri, Kishor

AU - Hackett, Thomas E.

AU - Sorosky, Joel

AU - Zaino, Richard

PY - 1992/12

Y1 - 1992/12

N2 - From November 1977 to July 1987, 300 consecutive patients with endometrial carcinoma clinically confined to the uterine corpus underwent primary surgery consisting of at least abdominal hysterectomy and adnexectomy. Patients with aggressive disease characteristics received postoperative radiotherapy. Forty-seven patients (16%) demonstrated recurrent disease from 2 to 125 (median of 12.8) months after surgery. Forty-seven percent of the recurrences were detected within the first year following surgery and 70% by 2 years after hysterectomy. Of the 47 recurrences, 29 were at distant sites, 16 were within the pelvis, and 2 consisted of both local and distant recurrences. Patients treated with pelvic radiotherapy after hysterectomy were more likely to experience distant, rather than local recurrences. Only 7 of the 148 patients (5%) treated with postoperative radiotherapy recurred in the pelvis. Approximately half of the recurrences were detected in asymptomatic individuals; physical examination and chest X-ray were the most useful means to detect disease in patients without symptoms. The combination of history, physical examination, pap smear, and chest X ray detected all of the recurrences. Actuarial survivals at 12, 24, and 36 months after recurrence were 42, 24, and 17%, respectively. The site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis. The identification of patients at risk of recurrence and more effective adjuvant therapy need to be developed in order to decrease the frequency of recurrence. In order to substantially improve the survival of patients with recurrent disease, more sensitive methods of detection, as well as more effective salvage therapy, will be required.

AB - From November 1977 to July 1987, 300 consecutive patients with endometrial carcinoma clinically confined to the uterine corpus underwent primary surgery consisting of at least abdominal hysterectomy and adnexectomy. Patients with aggressive disease characteristics received postoperative radiotherapy. Forty-seven patients (16%) demonstrated recurrent disease from 2 to 125 (median of 12.8) months after surgery. Forty-seven percent of the recurrences were detected within the first year following surgery and 70% by 2 years after hysterectomy. Of the 47 recurrences, 29 were at distant sites, 16 were within the pelvis, and 2 consisted of both local and distant recurrences. Patients treated with pelvic radiotherapy after hysterectomy were more likely to experience distant, rather than local recurrences. Only 7 of the 148 patients (5%) treated with postoperative radiotherapy recurred in the pelvis. Approximately half of the recurrences were detected in asymptomatic individuals; physical examination and chest X-ray were the most useful means to detect disease in patients without symptoms. The combination of history, physical examination, pap smear, and chest X ray detected all of the recurrences. Actuarial survivals at 12, 24, and 36 months after recurrence were 42, 24, and 17%, respectively. The site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis. The identification of patients at risk of recurrence and more effective adjuvant therapy need to be developed in order to decrease the frequency of recurrence. In order to substantially improve the survival of patients with recurrent disease, more sensitive methods of detection, as well as more effective salvage therapy, will be required.

UR - http://www.scopus.com/inward/record.url?scp=0027080513&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027080513&partnerID=8YFLogxK

U2 - 10.1016/0090-8258(92)90134-5

DO - 10.1016/0090-8258(92)90134-5

M3 - Article

C2 - 1473745

AN - SCOPUS:0027080513

VL - 47

SP - 323

EP - 327

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -