Women with first recurrence of endometrial cancer: who are they? An analysis of real-world data of the JAGO/NOGGO

首次复发子宫内膜癌的女性:她们是谁?JAGO/NOGGO真实世界数据分析

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Abstract

BACKGROUND: Recurrent endometrial cancer is still associated with poor survival rates. Daily life factors and comorbidities influence adherence to oncologic treatment. This study provides multicenter real-world data on patients life conditions and tumor's characteristics, which might contribute to treatment decision-making. MATERIALS AND METHODS: The study was performed retrospectively in five centers for gynecologic oncology. All patients treated for recurrent endometrial cancer between 2005 and 2022 were included, regardless of whether they received curative or palliative, surgical or medical treatment. Data collection was performed using the RedCap(®) software (Research Electronic Data Capture). RESULTS: In total, 277 patients with recurrent endometrial cancer were included in the study. The median age at time of recurrence was 70 years. 68.3 % of the patients had distant metastases, most of them (41 %) had pulmonary metastases. 63.9% of the patients had pelvic recurrences. 30.7 % of the patients had a second recurrence and 49.6 % of all patients died during the follow-up. 86.3 % of patients died due to endometrial cancer. Polypharmacy as an indicator of frailty was analyzed revealing that 34.2 % of the patients took more than five different drugs per day. CONCLUSION: The findings of this study indicate that the majority of patients with recurrent endometrial cancer undergo tumor-specific treatment rather than best supportive care. However, in cases of recurrence, the carcinoma itself remains a very frequent cause of death. Considering that a significant number of patients are living independently at the time of diagnosis, this study may contribute to treatment plans that prioritize strategies that enable patients to stay at home and maintain their autonomy. KEY MESSAGE: The present study suggests that most patients with recurrent endometrial cancer are in relatively good overall health, allowing them to undergo anti-tumor treatment. In general, they live independently and prefer active treatment over best supportive care.

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