The Efficacy of Local Treatment for Recurrent Endometrial Cancer

This study aimed to evaluate the efficacy of local treatment in patients with sporadic recurrent endometrial cancer.

We retrospectively reviewed patients who received treatment for first recurrence of endometrial cancer at our institution between 2012 and 2024. Sporadic recurrence was defined as the presence of up to three metastatic lesions within any single organ, with no more than five total lesions, excluding vaginal cuff recurrence. Patient characteristics, recurrence patterns, and clinical outcomes, including progression-free survival (PFS) and overall survival (OS), were compared between patients receiving local and systemic treatment.

A total of 67 patients met the eligibility criteria, of whom 37 received local treatment and 30 received systemic treatment. The baseline characteristics did not differ significantly between the two groups. All 11 patients with recurrent lesions involving the two anatomical regions were treated systemically. In the analysis restricted to single-region recurrences, 37 and 19 patients were included in the local and systemic treatment groups, respectively. In the single-region cohort, local treatment was associated with significantly improved progression-free survival (PFS) in Kaplan-Meier analysis (3-year PFS: 53.7% vs. 15.8%, p = 0.007) and univariate analysis (HR 0.40, p = 0.011), although this was not significant in multivariable analysis (HR 0.50, p = 0.063). No significant difference in overall survival was observed. Patients with shorter treatment-free intervals trended to have poorer outcomes.

Local treatment may provide a clinical benefit in selected patients with sporadic recurrent endometrial cancer confined to a single region, excluding those with vaginal cuff recurrence. However, this benefit may be influenced by patient selection. Further prospective studies are warranted.