Non-exenterative surgical management of recurrent endometrial carcinoma: patient characteristics and outcomes

Objectives: To determine what clinicopathologic variables are associated with survival outcomes for patients with recurrent endometrial cancer selected for non-exenterative surgery. Methods: All patients with recurrent endometrial cancer who underwent primary surgery between 1/1/2009 and 12/31/2017 at our center were retrospectively identified. We included patients with disease of endometrioid, serous, clear cell, and mixed histologies. Appropriate statistical tests were used. Results: We identified 350 patients with recurrent endometrial cancer; 57 (16%) were selected for secondary cytoreductive surgery (SUR) and 240 (69%) were medically managed (MM) with chemotherapy and/or radiation therapy (RT). The remaining patients were treated with hormonal therapy or did not undergo further treatment at recurrence. Median age was 62 years (range, 39-83) for the SUR and 66 years (range, 28-90) for the MM group (p Conclusions: Medical management with chemotherapy and/or RT is the most common treatment approach for first recurrence of endometrial cancer; however, surgery was associated with acceptable perioperative outcomes and may contribute to improved long-term survival in highly selected patients. Location and multi-site recurrence should not preclude non-exenterative surgical resection if deemed safe and feasible.