Patients with Vaginal Recurrence of Low Grade Endometrial Adenocarcinoma Do Not Have the Usual High Risk Factors Found in Patients with Other Recurrences: A Multi-Institutional Study
Elizabeth J Moschiano, Elizabeth D Euscher, Andres A Roma, Rouba Ali-Fehmi, Elizabeth E Frauenhoffer, Delia P Montiel, Insun Kim, Bojana Djordjevic, Denise A Barbuto, Anais Malpica, Sun R Hong, Elvio G Silva. Cedars-Sinai Medical Center, Los Angeles, CA
Background: The most common site of recurrence of low grade endometrial adenocarcinoma is the vagina; however, there is no clear explanation of how the tumor cells colonize the vagina.
Design: In this multi-institutional study we compiled data from 113 patients from 1991-2011 with FIGO 1 and 2 endometrial adenocarcinomas with recurrence, and 187 control cases that did not recur and had similar follow-up time (44 and 59 months, respectively). We further stratified this group and compared multiple risk factors for patients with vaginal recurrence, patients with recurrence in other sites, and control patients.
Results: There were no significant differences in the age of patients, type of surgical procedure, gross appearance or grade of the neoplasm.
There were significant differences in many high risk factors associated with extravaginal recurrence compared with our control group and patients with vaginal recurrence. These include average tumor size, average depth of myoinvasion, presence of microcystic, elongated and fragmented (MELF) pattern of myoinvasion, presence of lymphovascular invasion (LVSI), documented cervical involvement, and death secondary to disease (DOD).
|Site of Recurrence||Tumor Size (cm)||Depth Myoinvasion (%)||MELF n(%)||LVSI n(%)||Cx Involvement n(%)||DOD|