The impact of cytoreductive surgery in FIGO IV and recurrent endometrial cancer

Objective The aim of the study was to assess the oncological outcomes of cytoreductive surgery in FIGO IV and recurrent endometrial cancer.

Methods Retrospective, observational, single-center cohort study including patients with endometrial cancer FIGO IV stage disease undergoing primary cytoreductive surgery and recurrent endometrial cancer treated with secondary cytoreductive surgery between January 1999 and April 2022.

Results 115 patients were included in the present study. In the 53 patients with primary FIGO IV disease complete macroscopic resection was achieved in 42/53 (79.2%) cases. Median OS in these patients was 35 months and median PFS was 15 months. Sixty-two patients had cytoreductive surgery for relapsed endometrial cancer and complete macroscopic resection was achieved in 82.2%. Median OS in this population was 28 months and median PFS was 8.2 months.

Patients with complete macroscopic resection showed longer progression-free survival (PFS) and overall survival (OS) compared to those with residual disease (PFS: 15.1 vs 12.9 months; p=0,189; OS: 32.4 vs 17 months; p=0,130).

Median OS was 44.6 months (95 % CI 24,6- 64,6 months) in endometrioid subtype (72/115 pts) and 27.4 months (95 %CI 7.2-47.6 months) in other histotypes (p=0.114).

Major complications (>Clavien Dindo IIIB) were noted in 10/115 pts (8.7%), mortality rate was 0.9%.

Conclusion Complete macroscopic resection is feasible in selected patients with FIGO IV and relapsed endometrial cancer with an acceptable morbidity, and seemed to be related to superior outcome. However, its impact on prognosis should be further evaluated.

 

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Interessenkonflikt

Ich erkläre als korrespondierender Autor, dass ich oder einer bzw. mehrere meiner Ko-Autoren während der letzten 3 Jahre wirtschaftliche oder persönliche Verbindungen im oben genannten Sinne hatten:

Interessenkonflikt Details COI:Philipp Harter: Honoraria: Amgen, Astra Zeneca, GSK, Roche, Sotio, Stryker, Zai Lab, MSD, Clovis, Eisai

Advisory Board: Astra Zeneca, Roche, GSK, Clovis, Immunogen, MSD, Eisai

Research Funding (Inst): Astra Zeneca, Roche, GSK, Genmab, DFG, European Union, DKH, Immunogen, Clovis

Andreas du Bois: Honoraria / Institutional Grants for Advisory Boards and/or educational activities (last 3 yrs.):

•Roche

•Astra Zeneca / MSD

•GSK/Tesaro

•Clovis

•Pfizer

•Biocad

•Genmab / Seattle Genetics

•AMGEN

•Zodiac

Founder/ Chairman / Executive Board AGO Study Group

Co-Founder, Strategic Board and past president ENGOT

Past Chairman, Scientific committee, and faculty of consensus conferences GCIG and ESGO/ESMO

Past / Present member national guideline committees Breast- and Ovarian Cancer, and multiple further

committees, working groups, and editorial boards (eg. J Clin Oncol, Gynecol Oncol, Int J Gynecol Cancer)

Beyhan Ataseven: Honoraria: Roche, Tesaro/GSK, Celgene, Clovis, Astra Zeneca; Novartis, MSD, Eisai; Advisory Board: Roche, Tesaro/GSK, Amgen, MSD, Sanofi Aventis; Congress/travel support: Roche, Astra Zeneca, Tesaro/GSK, PharmaMar,

Nicole Concin: Consulting/Advisory: Seagen, Akesobio, Ensai, GSK, AstraZeneca, Mersana,

Seattle Genetics, eTheRNA immunotherapies NV

Travel Expenses: Roche, Genmab, Amgen

Educational fees: MSD, Medscape Oncology, TouchIME

Florian Heitz: personal fees/ adboards: NovoCure, PharmaMar

personal fees/ adboards and non-financial support: AstraZeneca, Roche, Tesaro, GSK, Clovis, amedes

non-financial support: NewOncology

Publication History

Article published online:
11 October 2022