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A 2nd SURGERY doubles survival time in recurrent endometrial cancer, study shows

lindaprocopio's picture
lindaprocopio
Posts: 2022
Joined: Oct 2008

If you have a recurrence of uterine cancer and there's any way they can completely cut out the new cancer, it sounds like your life span is SIGNIFICANTLY longer (DOUBLED +) than if you just have chemo to knock it back, according to this article from 2006:

Salvage cytoreductive surgery for recurrent endometrial cancer

Robert E. Bristowa, b, \l "cor1"\l "cor1", mailto:rbristo@jhmi.edumailto:rbristo@jhmi.edu, Antonio Santillana, Marianna L. Zahurakc, Ginger J. Gardnera, Robert L. Giuntoli IIa and Deborah K. Armstronga; The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21224; USA Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21224; USA
Department of Biostatistics, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA
Received 11 January 2006. Available online 2 May 2006.

Objective: To determine the survival impact of salvage cytoreductive surgery, and other prognostic variables, among patients with recurrent endometrial cancer.

Methods: All patients diagnosed with endometrial cancer recurrence between 7/1/97 and 6/30/05 were retrospectively identified from the tumor registry database. Demographic, pathological, and clinical data were abstracted from the medical record. Survival estimates were calculated using the Kaplan and Meier method. Univariate and multivariate regression analyses were used to identify characteristics associated with overall survival from time of recurrence.

Results: Sixty-one patients were identified with endometrial cancer recurrence a median of 18.5 months after initial diagnosis. Median age at recurrence was 63 years, and the median post-recurrence follow-up time was 22.0 months. Thirty-five patients underwent salvage cytoreductive surgery and had a median survival time of 28.0 months, compared to 13.0 months for patients treated non-surgically (P < 0.0001). Complete cytoreduction (no gross residual) was achieved in 23/35 surgical patients (65.7%). The median EBL was 350 cc and 28.6% of patients received blood products. There were no peri-operative deaths; however, 31.4% of patients experienced minor morbidity. Patients undergoing complete salvage cytoreduction had a median post-recurrence survival time of 39.0 months, compared to 13.5 months for those patients with gross residual disease (P = 0.0005). On multivariate analysis, salvage surgery and residual disease status were significant and independent predictors of post-recurrence survival.

Conclusions:
Complete salvage cytoreductive surgery for recurrent endometrial cancer is associated with prolonged post-recurrence survival compared to patients left with any gross residual disease. Additional studies are warranted to define appropriate surgical indications and selection criteria.

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6WG6-4JVTC4J-8-9&_cdi=6814&_user=10&_pii=S0090825806002320&_orig=search&_coverDate=10%2F31%2F2006&_sk=998969998&view=c&wchp=dGLzVtb-zSkWA&md5=a3494e7b3e604aefcd0e2c01eda2b024&ie=/sdarticle.pdfhttp://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6WG6-4JVTC4J-8-9&_cdi=6814&_user=10&_pii=S0090825806002320&_orig=search&_coverDate=10%2F31%2F2006&_sk=998969998&view=c&wchp=dGLzVtb-zSkWA&md5=a3494e7b3e604aefcd0e2c01eda2b024&ie=/sdarticle.pdf

maggie_wilson's picture
maggie_wilson
Posts: 616
Joined: Nov 2009

linda,

i'm printing that study and bringing it with me to the doctors if/when i need it. that's really excellent, heartening news. i'm so glad you enjoy ferreting out these studies; you do us all such a service.

sisterhood and hugs,
maggie

upsofloating's picture
upsofloating
Posts: 473
Joined: Dec 2009

This reminds of my breast ca recurrence - disagreement among doctors (medical onc, 2 radiation oncs, general and plastic surgeons), as to whether I should have surgery or just treat medically with tamoxifen and radiation. I went with radiation oncologist's opinion that the less cancer to treat, the more successful the treatment. My medical oncologist and doc who wanted to be lead in overall treatment was against surgery. Eleven years later I'm sure glad I opted for maximum cytoreduction prior to treatment. Also, surgery found much more extensive disease than was considered present.

I sometimes feel like I've had all the surgery I ever want to have -- but then again, a longer life beats all! Thanks for posting Linda. --Annie

jazzy1's picture
jazzy1
Posts: 1385
Joined: Mar 2010

I'm with Maggie, thanks for doing all this research for us and passing our way. I'm not up on where to look for research and how to understand the wording.

Okay so if I have recurrence looks like surgery might be a good option. Cross that bridge when we get there.

My question -- what type of research is out there for having chemo? Doesn't it leave some particles behind which can later turn toward the cancer side....to recurrence?

Thanks
Jan

maggie_wilson's picture
maggie_wilson
Posts: 616
Joined: Nov 2009

jan,

from what i understand, it's highly unlikely that surgery and chemo get all of the cancer cells; there are just too many microscopic ones. plus, the cells that return after chemo are hardier because they've survived the chemo. my chemo doc said that if there is a recurrence in a year or more, she uses the same chemo, but if it's in less than a year, uses a different one, precisely because the first didn't create a long enough remission, and because the next batch of cancer cells are stronger. in any case, this is my understanding. clearly the hope is to keep these remaining cancer cells weak/at bay/contained.....whatever we can do with diet, exercise, etc.

sisterhood,
maggie

Kaleena's picture
Kaleena
Posts: 1999
Joined: Nov 2009

Thank for the very informative information, Linda.

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