[Recurrence of stage I endometrial cancer: effect of prognostic factors on therapeutic results]

Endometrial carcinoma is the most common gynaecological invasive cancer. Since its incidence is increasing, more patients will develop recurrent disease. In an attempt to identify possible prognostic factors associated with survival, we reviewed the results of 45 patients treated in our department for recurrent clinical stage I endometrial carcinoma. All patients received primary therapy consisting of surgical resection. 16 patients developed recurrent disease after initial operative treatment and adjuvant radiotherapy. The minimum follow-up of 3 years was available in 43 patients and the actual 3-year survival rate was estimated 42% (median 16 months). Significant prognostic factors were recurrence site--vagina, 51% (17/33 pts) vs extravaginal, 20% (2/10 pts) (p = 0.01), and histological cell type--non-papillary carcinoma, 50% (17/34 pts) vs papillary adenocarcinoma, 22% (2/9 pts) (p = 0.02). Late recurrences have been reported to carry a better prognosis, than those that recur early. In the present study, time of onset did not appear to be a significant factor--recurrence occurs within 24 months, 36% (9/25 pts) vs recurrence appearing after 2 years, 55% (10/18 pts). We suggest, that systemic therapy should be prospectively evaluated in high-risk patients. Selected patients with recurrent disease--cases of non-papillary histological cell type and vaginal recurrence--can be cured by radiotherapy.