Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_19_3507 - Prognostic Importance of Distant Metastatic Disease Sites in Endometrial Cancer: A Population-Based Study of 4577 Patients

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Prognostic Importance of Distant Metastatic Disease Sites in Endometrial Cancer: A Population-Based Study of 4577 Patients
J. Budnik1, M. D. Stolten1, M. T. Milano2, and K. C. Bylund1; 1Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, 2University of Rochester Medical Center, Rochester, NY

Purpose/Objective(s): The majority of women diagnosed with endometrial cancer have early stage disease which has an excellent prognosis with definitive treatment. However, endometrial cancers also readily metastasize to distant sites and therapeutic options for metastatic patients remain limited. To date, few population-based studies have examined the impact of distant metastatic disease sites on the survival of endometrial cancer patients. We aimed to investigate this using the Surveillance, Epidemiology, and End Results (SEER) database.

Materials/Methods: We included 4577 patients from the SEER database diagnosed with metastatic endometrial cancer from 2010-2014. We then identified those patients coded as having metastatic disease in bone, brain, liver, and lung. Kaplan-Meier analyses, log-rank tests, and both univariate and multivariate Cox proportional hazards models were used to examine the impact of metastatic disease sites on overall survival (OS).

Results: Most patients in the cohort were white (n=3304, 72.2%). Median age at diagnosis was 65 years and median OS was 14 months. Endometrioid (n=1301, 28.4%), serous (n=971, 21.2%) and carcinosarcoma (n=749, 16.4%) histologies were the most common. The majority of patients (n=2767, 60.5%) had no documented metastases in the bone, brain, liver, or lung (“M1NOS-group”), likely reflecting pelvic-abdominal metastases not captured in the SEER registries. With Cox regression accounting for age at diagnosis, race, histology, grade, T stage, and N stage, patients coded as harboring extra-abdominal/pelvic metastatic disease in only the bone (HR=1.82, p<0.001), brain (HR=2.93, p<0.001), liver (HR=1.50, p<0.001), or lung (HR=1.50, p<0.001) had poorer OS relative to those in the M1NOS-group. Likewise, patients coded as harboring multiple extra-abdominal/pelvic sites of metastatic disease had poorer OS relative to the M1NOS-group (p<0.001). Black race (HR=1.29, p<0.001), and carcinosarcoma histology (HR=1.54, p<0.001) were also associated with poorer OS on multivariate analysis relative to white patients and endometrioid histology respectively.

Conclusion: This hypothesis-generating study suggests that the prognosis of patients diagnosed with metastatic endometrial cancer not located in bone, brain, liver, or lung is improved relative to those harboring disease in any one, or a combination of these sites. This may inform future therapeutic studies which seek to improve the prognosis of patients with metastatic endometrial cancer.

Author Disclosure: J. Budnik: Resident physician; University of Rochester. M.D. Stolten: Resident physician; University of Rochester. M.T. Milano: Honoraria; UpToDate. K.C. Bylund: None.

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