Hematogenous metastases in patients with Stage I or II endometrial carcinoma

Strahlenther Onkol. 2011 Dec;187(12):806-11. doi: 10.1007/s00066-011-2250-6. Epub 2011 Nov 17.

Abstract

Aims: The aim of this study was to present the characteristics, methods of treatment, and the survival of patients with hematogenous metastases from endometrial carcinoma, free from local and other distant recurrences.

Patients and methods: In 1,610 endometrial carcinoma patients managed with surgery and postoperative radiotherapy, we defined hematogenous metastases as a tumor spread to the lung or other sites via hematogenous routes.

Results: A total of 110 patients with stage I and II endometrial carcinoma, presenting with 134 metastases sites (69 in the lungs, 32 in the liver, 23 in the bones, and 10 in the brain), were observed. Progestin and combination chemotherapy were the most commonly used therapies. Primary treatment consisted of surgery in patients with solitary metastases to the lung (30 patients), liver (2 patients), and brain (2 patients). Radiotherapy was performed in 32 patients with metastases to the brain and bones. Presenting with a 36-month survival rate were 11.6% (8/69) of patients with metastases to the lungs, 6.3% (2/32) of patients with metastases to the liver, 8.7% (2/23) of patients with metastases to the bones, and 20.0% (2/10) of patients with metastases to the brain.

Conclusions: Hormonal therapy and chemotherapy play a major role in the palliative management of patients with hematogenous metastases from endometrial carcinoma to the liver, lungs, and bones. Radical treatment in patients with metastases to the lung or liver consists of resection of the metastasis combined with chemo- and/or hormonotherapy for metastases to the bones treatment consists of radiotherapy + chemotherapy, for metastasis to the brain treatment consists of resection combined with radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Neoplasms / mortality
  • Bone Neoplasms / pathology*
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary*
  • Bone Neoplasms / surgery
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Carcinoma, Endometrioid / pathology*
  • Carcinoma, Endometrioid / radiotherapy
  • Carcinoma, Endometrioid / secondary*
  • Carcinoma, Endometrioid / surgery
  • Chemoradiotherapy, Adjuvant
  • Combined Modality Therapy
  • Disease Progression
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / radiotherapy
  • Endometrial Neoplasms / surgery
  • Female
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / radiotherapy
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery
  • Middle Aged
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / pathology*
  • Neoplastic Cells, Circulating / radiation effects
  • Retrospective Studies
  • Survival Rate