Endometrial carcinoma: better prognosis for asymptomatic recurrences than for symptomatic cases found by routine follow-up

Ueda, Yutaka; Enomoto, Takayuki; Egawa-Takata, Tomomi; Miyatake, Takashi; Yoshino, Kiyoshi; Fujita, Masami; Matsuzaki, Shinya; Yokoyama, Tadashi; Miyoshi, Yukari; Kimura, Tadashi

doi:10.1007/s10147-010-0080-7

Cited by 21 publications

(16 citation statements)

References 17 publications

(25 reference statements)

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“…Women diagnosed at a pre-scheduled visit due to symptoms had a higher educational level and more often high-risk disease compared to symptomatic women diagnosed at regular follow-up. Previous studies have used retrospectively collected survival data to conclude on the efficacy and justification of follow-up visits [3,4,[15][16][17][18][19][20][21]. In addition to the present study, a minority of the studies [3,4] found a better survival of women with asymptomatic recurrence and it seems tempting to conclude that follow-up visits improve survival.…”

Section: Discussioncontrasting

confidence: 44%

“…Most of the studies conclude that the majority [70% (95% CI 65-75)] of recurrences are symptomatic [2], and the survival rates of asymptomatic and symptomatic cases are similar thus challenging the current follow-up strategy [1,2]. However, a few studies demonstrated a better survival in asymptomatic cases [3,4] which may be interpreted as a need for regular follow-up.…”

mentioning

confidence: 99%

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Detection of recurrence in early stage endometrial cancer – the role of symptoms and routine follow-up

et al. 2017

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Background: Considerable controversy remains as to the optimal organization of endometrial cancer follow-up. Aim: To evaluate the relationship between the way recurrence was detected and survival after treatment for endometrial cancer. Further, to identify characteristics associated with a pre-scheduled examination in women with symptomatic recurrence. Material and methods: All women with early stage endometrial cancer during [2005][2006][2007][2008][2009] were included in a population-based historical cohort derived from the Danish Gynecological Cancer Database. Women diagnosed with recurrence within three years after primary surgery and the mode of recurrence detection were identified from hospital charts: asymptomatic recurrence detected at regular follow-up, symptomatic recurrence detected at regular follow-up or symptomatic recurrence detected in between follow-up. Survival of women with symptomatic and asymptomatic disease was compared. Furthermore, characteristics associated with self-referral as compared to presenting symptoms at regular follow-ups were identified using univariate analyses. Results: In total, 183 cases of recurrence (7%) were identified in the cohort of 2612 women. Of these, 65.5% were symptomatic with vaginal bleeding as the most prevalent symptom. Asymptomatic women had a significantly better three-year survival rate compared to symptomatic women (80.3% vs. 54.3%, p < 0.01). A total of 2.3% of the entire population had an asymptomatic recurrence. Women diagnosed at a pre-scheduled visit due to symptoms had a higher educational level (p ¼ 0.03) and more often high-risk disease (p ¼ 0.02) than symptomatic women diagnosed at regular follow-up. Conclusion: Early stage endometrial cancer carries a low risk of recurrence. Survival appears to be superior in asymptomatic patients, but length-time bias, i.e. the effect of aggressive tumor biology in symptomatic recurrences, may bias results in non-randomized controlled trials. Well educated patients with symptoms of recurrence more often sought medical attendance compared to less educated counterparts. This should be considered if patient-initiated follow-up is the standard care.

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Section: Discussioncontrasting

confidence: 44%

mentioning

confidence: 99%

Detection of recurrence in early stage endometrial cancer – the role of symptoms and routine follow-up

et al. 2017

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“…A study from 2010 of 271 endometrial cancers indicates that this could be the case, because the authors found an increase in progression-free survival in asymptomatic cases found at routine follow-up compared to symptomatic cases, this being especially true in patients who underwent chemotherapy as their adjuvant therapy. 24 In the present study, 6.3% of low and 22% of intermediate risk recurred. Of these, 40% were diagnosed more than 2 years and 13% more than 5 years after the primary surgery.…”

Section: Discussionsupporting

confidence: 46%

Omitting Adjuvant Radiotherapy in Endometrial Cancer Increases the Rate of Locoregional Recurrences but Has no Effect on Long-Term Survival

Ørtoft¹,

Hansen

Bertelsen

2013

International Journal of Gynecological Cancer

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“…The commonest type, which is the endometrioid endometrial cancer (EEC) or type I, has an underlying endometrial hyperplasia, and low-grade and minimal myometrial invasion. EEC (4). Much of the ongoing research still focuses on identifying biomarkers for early detection, understanding the pathophysiology, and monitoring the course of treatments.…”

Section: Introductionmentioning

confidence: 99%

Laser Capture Microdissection with Genome-Wide Expression Profiling Displayed Gene Expression Signatures in Endometrioid Endometrial Cancer

Mokhtar

Ramzi²,

Yin-Ling

et al. 2012

Cancer Investigation

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This research determined genes contributing to the pathogenesis of endometrioid endometrial cancer (EEC). Eight pairs of microdissected EEC samples matched with normal glandular epithelium were analyzed using microarray. Unsupervised analysis identified 162 transcripts (58 up- and 104 down-regulated) that were differentially expressed (p < .01, fold change ≥ 1.5) between both groups. Quantitative real-time polymerase chain reaction (qPCR) validated the genes of interest: SLC7A5, SATB1, H19, and ZAK (p < .05). Pathway analysis revealed genes involved in acid amino transport, translation, and chromatin remodeling (p < .05). Laser capture microdissection (LCM) followed by microarray enabled precise assessment of homogeneous cell population and identified putative genes for endometrial carcinogenesis.

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Endometrial carcinoma: better prognosis for asymptomatic recurrences than for symptomatic cases found by routine follow-up

Cited by 21 publications

References 17 publications

Detection of recurrence in early stage endometrial cancer – the role of symptoms and routine follow-up

Detection of recurrence in early stage endometrial cancer – the role of symptoms and routine follow-up

Omitting Adjuvant Radiotherapy in Endometrial Cancer Increases the Rate of Locoregional Recurrences but Has no Effect on Long-Term Survival

Laser Capture Microdissection with Genome-Wide Expression Profiling Displayed Gene Expression Signatures in Endometrioid Endometrial Cancer

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