Prognostic significance of the treatment-free interval in patients with recurrent endometrial cancer

Abstract Objective To identify prognostic factors of recurrent endometrial cancer, and clarify whether the treatment-free interval (TFI) predicts outcome in a wide spectrum of patients. Study design The clinical data of 60 patients treated for recurrent stage I–IV endometrial cancer between 1997 and 2012 were reviewed retrospectively. The Kaplan–Meier method and Cox regression analysis were used to estimate overall survival (OS) following recurrence and determine the factors influencing outcomes. Results The median age at initial treatment was 59 (range 38–80) years and the median post-recurrence overall survival time was 40.0 (range 1.8–156.7) months. Multivariate analysis showed lymph node metastasis (hazard ratio (HR) 2.80; 95% confidence interval (95%CI) 1.29–6.09; p = 0.009), TFI (HR 0.33; 95% CI 0.15–0.76; p = 0.008), and symptomatic recurrence (HR 2.31, 95% CI 1.11–4.83, p = 0.0025) were independent prognostic factors. Patients whose tumors recurred after a TFI ≥ 12 months had better response rates than did those with a TFI < 12 months ( p < 0.001). Conclusion TFI is a significant prognostic factor in recurrent endometrial cancer. Furthermore, the effect of chemotherapy on recurrent endometrial cancer is probably influenced by the duration of TFI.