Role of less commonly agreed risk factors on disease recurrence in endometrial cancer: a propensity scorematched comparison

OBJECTIVE: To compare the clinicopathologic features of patients with endometrial cancer (EC) with recurrent disease with a primary surgery, stage, grade, and tumor histotype-matched cohort of patients without recurrence. MATERIALS AND METHODS: Patients with EC who were surgically treated at a single tertiary care institution between 2005 and 2015 were enrolled in this study. The dataset included 381 consecutive patients with EC, of which 31 (8.1%) had disease recurrence. Data consisting of age at surgery, CA- 125 concentration at diagnosis, number of lymph nodes harvested, growth pattern of the primary tumor, location of the primary tumor within the endometrium, tumor histotype, tumor grade, disease stage, adjuvant therapy, disease recurrence, time to recurrence, CA-125 concentration at recurrence, clinical and imaging findings at recurrence, and treatment modalities used for recurrent disease were extracted from the institutional database. RESULTS: After 1-to-1 propensity-score matching of patients with and without recurrence, the clinicopathologic features of 26 patients from each group were compared. Patients with recurrent disease were found to have a significantly higher CA-125 concentration at initial diagnosis (p<0.001) and different tumor growth pattern (p=0.019) than patients without disease recurrence. The papillary growth pattern of the primary tumor was significantly associated with disease recurrence as compared with polypoid and infiltrative patterns. Omental involvement, papillary tumor growth, and advanced age were associated with increased mortality. CONCLUSION: Our results indicated that higher CA-125 concentrations at initial diagnosis and papillary growth pattern of primary tumors were found to be associated with disease recurrence.