Prognostic significance of the treatment-free interval in patients with recurrent endometrial cancer

ObjectiveTo identify prognostic factors of recurrent endometrial cancer, and clarify whether the treatment-free interval (TFI) predicts outcome in a wide spectrum of patients.Study designThe clinical data of 60 patients treated for recurrent stage I-IV endometrial cancer between 1997 and 2012 were reviewed retrospectively. The Kaplan-Meier method and Cox regression analysis were used to estimate overall survival (OS) following recurrence and determine the factors influencing outcomes.ResultsThe median age at initial treatment was 59 (range 38-80) years and the median post-recurrence overall survival time was 40.0 (range 1.8-156.7) months. Multivariate analysis showed lymph node metastasis (hazard ratio (HR) 2.80; 95% confidence interval (95%CI) 1.29-6.09; p = 0.009), TFI (HR 0.33; 95% CI 0.15-0.76; p = 0.008), and symptomatic recurrence (HR 2.31, 95% CI 1.11-4.83, p = 0.0025) were independent prognostic factors. Patients whose tumors recurred after a TFI ≥ 12 months had better response rates than did those with a TFI < 12 months (p < 0.001).ConclusionTFI is a significant prognostic factor in recurrent endometrial cancer. Furthermore, the effect of chemotherapy on recurrent endometrial cancer is probably influenced by the duration of TFI.