Table 1.
Clinicopathologic characteristics among all recurrences compared across treatment modalities (N = 376).
| Variable | All recurrences | SCS | Medical management | Hormonal therapy | No therapy | p-Value† | p-Value |
|---|---|---|---|---|---|---|---|
| (N = 376) | (N = 61) | (N = 257) | (N = 32) | (N = 26) | (SCS vs MM)†† | ||
| 1A: Clinicopathologic characteristics at the time of initial diagnosis and primary surgery | |||||||
| Age at initial diagnosis, years | |||||||
| Median (range) | 66 (28–93) | 62 (39–83.3) | 66 (28–90) | 69.5 (47–86) | 67.5 (33–92) | 0.004 | 0.004 |
| Age ≤70 | 254 (67.6) | 50 (82) | 174 (67.7) | 16 (50) | 14 (53.8) | 0.005 | 0.029 |
| Age > 70 | 122 (32.4) | 11 (18) | 83 (32.3) | 16 (50) | 12 (46.2) | ||
| BMI at initial diagnosis, kg/m2 | |||||||
| Median (range) | 29.5 (14.2–60.3) | 25.3 (19.1–43) | 29.7 (14.2–60.3) | 28.5 (15.8–51) | 25.3 (19.1–43) | 0.349 | 0.739 |
| Normal (BMI < 25) | 93 (24.7) | 13 (21.3) | 62 (24.1) | 7 (21.9) | 11 (42.3) | 0.165* | 0.882 |
| Overweight (25 ≤BMI < 30) | 104 (27.7) | 16 (26.2) | 70 (27.2) | 14 (43.8) | 4 (15.4) | ||
| Obese (BMI ≥30) | 179 (47.6) | 32 (52.5) | 125 (48.6) | 11 (34.4) | 11 (42.3) | ||
| Progression-free survival (PFS1) (months) | |||||||
| Median (range) | 14.3 (0.2–102.2) | 19.4 (2.4–88.3) | 13.3 (0.2–102.2) | 15.5 (2.5–92.4) | 11.6 (1.9–62.2) | 0.002 | <0.001 |
| Histology | |||||||
| Endometrioid | 183 (48.7) | 37 (60.7) | 117 (45.5) | 18 (56.3) | 11 (42.3) | 0.214* | 0.033 |
| Serous | 146 (38.8) | 15 (24.6) | 109 (42.4) | 11 (34.4) | 11 (42.3) | ||
| Clear Cell/Mixed | 47 (12.5) | 9 (14.8) | 31 (12.1) | 3 (9.4) | 4 (15.4) | ||
| FIGO Grade | 0.016* | 0.022 | |||||
| G1 | 62 (16.5) | 12 (19.7) | 37 (14.4) | 11 (34.4) | 2 (7.7) | ||
| G2 | 71 (18.9) | 18 (29.5) | 43 (16.7) | 5 (15.6) | 5 (19.2) | ||
| G3/high-grade histology | 243 (64.6) | 31 (50.8) | 177 (68.9) | 16 (50) | 19 (73.1) | ||
| Stage | |||||||
| I | 162 (43.1) | 35 (57.4) | 108 (42) | 11 (34.4) | 8 (30.8) | 0.065* | 0.014 |
| II | 27 (7.2) | 2 (3.3) | 19 (7.4) | 3 (9.4) | 3 (11.5) | ||
| III | 96 (25.5) | 18 (29.5) | 63 (24.5) | 9 (28.1) | 6 (23.1) | ||
| IV | 91 (24.2) | 6 (9.8) | 67 (26.1) | 9 (28.1) | 9 (34.6) | ||
| ≥Grade 3 Complication | |||||||
| No | 363 (96.5) | 60 (98.4) | 250 (97.3) | 30 (93.8) | 23 (88.5) | 0.069 | 1 |
| Yes | 13 (3.5) | 1 (1.6) | 7 (2.7) | 2 (6.3) | 3 (11.5) | ||
| Length of hospital stay, days | |||||||
| Median (range) | 1 (0–49) | 1 (0–6) | 1 (0–49) | 2 (0–15) | 2.5 (0–18) | 0.002 | 0.003 |
| Residual disease after primary surgery | |||||||
| Absent | 348 (92.6) | 61 (100) | 234 (91.1) | 30 (93.8) | 23 (88.5) | 0.033 | 0.011 |
| Present | 28 (7.4) | 0 (0) | 23 (8.9) | 2 (6.3) | 3 (11.5) | ||
| Adjuvant Therapy after primary surgery | |||||||
| No | 62 (16.5) | 12 (19.7) | 41 (16) | 5 (15.6) | 4 (15.4) | 0.891 | 0.452 |
| Yes | 314 (83.5) | 49 (80.3) | 216 (84) | 27 (84.4) | 22 (84.6) | ||
| Adjuvant Chemotherapy after primary surgery | |||||||
| No | 133 (35.4) | 21 (34.4) | 91 (35.4) | 11 (34.4) | 10 (38.5) | 0.988 | 1 |
| Yes | 243 (64.6) | 40 (65.6) | 166 (64.6) | 21 (65.6) | 16 (61.5) | ||
| Adjuvant Radiation after primary surgery | |||||||
| No | 173 (46) | 19 (31.1) | 123 (47.9) | 15 (46.9) | 16 (61.5) | 0.039 | 0.022 |
| Yes | 203 (54) | 42 (68.9) | 134 (52.1) | 17 (53.1) | 10 (38.5) | ||
| Type of radiation therapy | |||||||
| IVRT | 144 (70.9) | 26 (61.9) | 100 (74.6) | 13 (76.5) | 5 (50) | 0.101 | 0.097 |
| EBRT | 53 (26.1) | 16 (38.1) | 30 (22.4) | 3 (17.6) | 4 (40) | ||
| IVRT/EBRT | 6 (3.0) | 0 (0) | 4 (3) | 1 (5.9) | 1 (10) | ||
| 1B: Clinicopathologic characteristics at the time of recurrence | |||||||
| Size of largest recurrent tumor (cm)^ | |||||||
| Median (range) | 2.2 (0.2–19.8) | 2.6 (0.5–12) | 2.2 (0.2–19.8) | 2.5 (0.5–12) | 2.4 (0.6–19.2) | 0.003 | 0.148 |
| Multiplicity of sites of recurrence | |||||||
| Single | 201 (53.5) | 46 (75.4) | 125 (48.6) | 16 (50) | 14 (53.8) | 0.002 | <0.001 |
| Multiple | 175 (46.5) | 15 (24.6) | 132 (51.4) | 16 (50) | 12 (46.2) | ||
| Sites of recurrence | |||||||
| Pelvic alone | 72 (19.1) | 11 (18) | 59 (23) | 0 (0) | 2 (7.7) | 0.004* | 0.109 |
| Nodal alone | 60 (16) | 10 (16.4) | 35 (13.6) | 11 (34.4) | 4 (15.4) | ||
| Pelvic and nodal | 16 (4.3) | 3 (4.9) | 11 (4.3) | 1 (3.1) | 1 (3.8) | ||
| Distant +/− pelvic | 195 (51.9) | 36 (59) | 124 (48.2) | 18 (56.3) | 17 (65.4) | ||
| Peritoneal carcinomatosis alone | 33 (8.8) | 1 (1.6) | 28 (10.9) | 2 (6.3) | 2 (7.7) | ||
| Subsequent lines of therapy | |||||||
| Median (range) | 1 (1–8) | 1 (1–6) | 2 (1–8) | 2 (1–7) | – | <0.001 | <0.001 |
Values are presented as numbers (%) unless otherwise specified.
SCS, secondary cytoreductive surgery; BMI, body mass index; IVRT, intravaginal radiation therapy; EBRT, external beam radiation therapy; FIGO, International Federation of Gynecology and Obstetrics.
Bold denotes significant p-values.
^
Twenty-four data points not available.
†
p-values with * are obtained using Monte Carlo estimation for exact test; other p-values are obtained using Kruskal Wallis test for continuous and Fisher’s exact test for categorical.
††
p-values are obtained using Fisher’s exact test for categorical and Willcoxon rank-sum test for continuous.