Broadening treatment to battle recurrence of endometrial cancer

Mayo Clinic researchers studying endometrial cancer have found that patients at risk for relapse based on identified risk factors had a 46 percent probability of experiencing recurrence within five years despite treatment with state-of-the-art therapy.

The study’s findings are important for women deemed at risk because they might need additional treatment, which physicians should consider in their treatment plans for their patients, says Karl Podratz, M.D., Ph.D., the study’s lead researcher.

The risk factors the researchers identified were specific characteristics of tissues that had been removed during surgery and were analyzed by microscope. Researchers also said risk factors included whether the tumors were confined to the uterus or if the disease had spread outside the uterus.

In the United States, endometrial cancer is the most common malignancy of the female reproductive tract. Only breast, colon and lung cancers are more prevalent in women. During 2004, it was estimated 40,320 new cases of endometrial cancer would be diagnosed in the United States and 7,090 women would die from the disease.

The study looked at 1,109 patients with endometrial cancer who had surgical treatment at Mayo Clinic in Rochester from 1984 to 1996. Based on data from their medical records, 915 patients with endometrial cancer met the following criteria to be included in the study: treatment included hysterectomy, and no other malignancy was diagnosed within five years before or after the diagnosis of endometrial cancer.

“The 46 percent recurrence rate for the at-risk patients among the expected cases of newly diagnosed endometrial cancer in 2004 is close to the number of deaths the disease is expected to cause in that period,” says Dr. Podratz. “We feel that to maximize outcomes, approximately one-third of the patients with endometrial cancer in the United States, or about 14,000 women, would potentially benefit from enrollment in clinical trials addressing the new target-based therapeutic approach.”

The new approach for treatment would be based on the inclusion of risk factors identified in previous studies and categorization of patients according to their risks for different patterns of recurrence, such as in the lungs, abdomen or lymph nodes. In doing this, physicians would be able to better predict and focus treatments on anticipated routes of the disease and its relapse.