Predictive Factors and Outcomes in the Management of Stage IB Endometrial Cancer
A Retrospective Study on Recurrence and Adjuvant Treatment
DOI:
https://doi.org/10.56226/98Keywords:
Endometrial Cancer, Stage IB, POLE, Radiotherapy, Recurrence, Health ManagementAbstract
Introduction: Endometrial cancer is one of the most common gynaecological malignancies, especially in postmenopausal women. This case study analyzes the clinical course of a 52-year-old female patient diagnosed in April 2020 with low-grade endometrioid adenocarcinoma, stage IB by the FIGO system. After total hysterectomy with bilateral salpingo-oophorectomy, the patient underwent adjuvant radiotherapy due to the presence of risk factors, such as obesity and limited myometrial invasion. Despite the favourable prognosis associated with the ultra mutated POLE molecular profile, the patient presented metastatic recurrence three years after the initial treatment. Methodology: This was a retrospective analysis of the patient's clinical data, including medical history, therapeutic interventions, and outcomes. Management of recurrence included systemic chemotherapy with carboplatin and paclitaxel, associated with palliative radiotherapy for local control. The investigation detailed the factors that contributed to clinical failure, such as obesity, characteristics of the occupational environment, and limitations of the therapeutic strategies adopted. Results: Partial control of metastatic disease, with reduced symptoms and improved quality of life during treatment of recurrence. However, the disease progressed systemically approximately 18 months after intervention, leading to death in a comprehensive palliative care setting. This case highlights the importance of integrative approaches in managing endometrial cancer, considering the interaction between clinical, molecular and psychosocial factors. Clinical failure in the presence of a favourable molecular profile reinforces the need for more personalized therapeutic strategies, including the use of immunotherapy in specific scenarios. Conclusion: The integration of innovative therapies, improved monitoring protocols, and psychosocial support are critical to optimizing outcomes in patients with gynecologic cancer. This case highlights the relevance of additional studies exploring the combination of technological advances and patient-centred care to address the challenges of this condition.
References
Charbotel, B., Massardier-Pilonchery, A., Fort, E., Dananché, B., Févotte, J., Confavreux-Romestaing, C., & Bergeret, A. (2013). Occupational trichloroethylene exposure and cervical pathology: a case-control study. The Annals of occupational hygiene, 57(3), 407–416. https://doi.org/10.1093/annhyg/mes075 DOI: https://doi.org/10.1093/annhyg/mes075
Creutzberg, C. L., van Putten, W. L., Koper, P. C., Lybeert, M. L., Jobsen, J. J., Wárlám-Rodenhuis, C. C., De Winter, K. A., Lutgens, L. C., van den Bergh, A. C., van de Steen-Banasik, E., Beerman, H., & van Lent, M. (2000). Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet (London, England), 355(9213), 1404–1411. https://doi.org/10.1016/s0140-6736(00)02139-5 DOI: https://doi.org/10.1016/S0140-6736(00)02139-5
da Silva Barreto, G., Brito do Nascimento, J., Cristina Santos de Almeida, K., Carlos Marcolino Neto, J., & Lucas Ferreira Luz da Silva, S. (2024). The CRISPR therapy: A revolutionary breakthrough in genetic medicine. International Healthcare Review (online). https://doi.org/10.56226/88 DOI: https://doi.org/10.56226/88
Datta, A., Thomas, V., Sebastian, A., George, R., Thomas, A., Ram, T. S., Daniel, S., Reka, K., & Peedicayil, A. (2023). The clinico pathological features and survival in serous endometrial cancers. Gynecologic oncology reports, 47, 101194. https://doi.org/10.1016/j.gore.2023.101194 DOI: https://doi.org/10.1016/j.gore.2023.101194
Dobroski, A. U. B., Duarte, B. P. F., Tanganelli, C. B., Neto, E. M. O., Naddeo, M., Valdujo, N. S., Maluf, G., & Uyeda, M. (2025). Impact of Mutations in DNA Repair Genes in Lynch Syndrome: A Systematic Literature Review. International Healthcare Review (online). https://doi.org/10.56226/93 DOI: https://doi.org/10.56226/93
Elshaikh, M. A., Vance, S., Gaffney, D. K., Biagioli, M., Jhingran, A., Jolly, S., Kidd, E., Lee, L. J., Li, L., Moore, D. H., Rao, G. G., Wahl, A. O., Williams, N. L., Yashar, C. M., Small, W., Jr, & Expert Panel on Radiation Oncology–Gynecology: (2016). ACR Appropriateness Criteria® Management of Recurrent Endometrial Cancer. American journal of clinical oncology, 39(5), 507–515. https://doi.org/10.1097/COC.0000000000000318 DOI: https://doi.org/10.1097/COC.0000000000000318
Hansen, J., Sallmén, M., Seldén, A. I., Anttila, A., Pukkala, E., Andersson, K., Bryngelsson, I. L., Raaschou-Nielsen, O., Olsen, J. H., & McLaughlin, J. K. (2013). Risk of cancer among workers exposed to trichloroethylene: analysis of three Nordic cohort studies. Journal of the National Cancer Institute, 105(12), 869–877. https://doi.org/10.1093/jnci/djt107 DOI: https://doi.org/10.1093/jnci/djt107
Horowitz, N. S., Peters, W. A., 3rd, Smith, M. R., Drescher, C. W., Atwood, M., & Mate, T. P. (2002). Adjuvant high dose rate vaginal brachytherapy as treatment of stage I and II endometrial carcinoma. Obstetrics and gynecology, 99(2), 235–240. https://doi.org/10.1016/s0029-7844(01)01672-6 DOI: https://doi.org/10.1097/00006250-200202000-00013
INCA. Coordenação de Prevenção e Vigilância. Estimativa 2023: Incidência de Câncer no Brasil. Rio de Janeiro: Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. 2023
Kenupp, M. G., Vianna, A., Uyeda, M., & Maluf, G. (2024). On Patients with Colorectal Cancer : Associations, prognosis, survival and effects of therapy performed in the intestinal microbiota. International Healthcare Review (online). https://doi.org/10.56226/83 DOI: https://doi.org/10.56226/83
Keys, H. M., Roberts, J. A., Brunetto, V. L., Zaino, R. J., Spirtos, N. M., Bloss, J. D., Pearlman, A., Maiman, M. A., Bell, J. G., & Gynecologic Oncology Group (2004). A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecologic oncology, 92(3), 744–751. https://doi.org/10.1016/j.ygyno.2003.11.048 DOI: https://doi.org/10.1016/j.ygyno.2003.11.048
Marinho, S., Brito, M., & Clarindo, Ítalo A. L. P. (2025). The Influence of Cancer on the Sexual and Emotional Health of Young People: A Longitudinal Analysis. International Healthcare Review (online). https://doi.org/10.56226/94 DOI: https://doi.org/10.56226/94
Marques da Silva, M., Matias Cunha, C., Aquino, C., Aquino, L., & Fernanda Pizo Ferreira, P. (2025). SBRT for Uncomplicated Bone Metastases in the Spine from Lung Cancer: A literature Review. International Healthcare Review (online). https://doi.org/10.56226/92 DOI: https://doi.org/10.56226/92
Nair, V., Dau, H., Vidler, M., AboMoslim, M., Mutamba, B., Scott, M., Nesbitt, Z., Deodatha, J., Byiringiro, S. D., Niyotwiringiye, C., Mithani, N., Smith, L., Ogilvie, G., & Rulisa, S. (2023). Understanding the cervical cancer self-collection preferences of women living in urban and rural Rwanda. PLOS global public health, 3(9), e0002135. https://doi.org/10.1371/journal.pgph.0002135 DOI: https://doi.org/10.1371/journal.pgph.0002135
Silva Ribeiro, L., & Cristina Uniat, K. (2025). On Public Health and New Prostate Cancer Screening Strategies: Comparison of Methods and Results for Prevention. International Healthcare Review (online). https://doi.org/10.56226/97 DOI: https://doi.org/10.56226/97
Slack, R., Young, C., Rushton, L., & British Occupational Cancer Burden Study Group (2012). Occupational cancer in Britain. Female cancers: breast, cervix and ovary. British journal of cancer, 107 Suppl 1(Suppl 1), S27–S32. https://doi.org/10.1038/bjc.2012.115 DOI: https://doi.org/10.1038/bjc.2012.115
Song, C., & Xie, H. (2023). On Disparities in Breast Cancer Screening: An Analysis of Behavioral Risk Factor Surveillance Survey Data related to Racial/ Ethnic characteristics. International Healthcare Review (online). https://doi.org/10.56226/53 DOI: https://doi.org/10.56226/53
Uyeda, M. (2022). On a Global Agenda for Oncology Research: From Biomarker studies to post-genomic technologies. International Healthcare Review (online), 1(1). https://doi.org/10.56226/ihr.v1i1.9 DOI: https://doi.org/10.56226/ihr.v1i1.9
Zouridis, A., Zarrindej, K., Rencher, J., Pappa, C., Kashif, A., Smyth, S. L., Sadeghi, N., Sattar, A., Damato, S., Ferrari, F., Laganà, A. S., Abdalla, M., Kehoe, S., Addley, S., & Soleymani Majd, H. (2023). The Prognostic Characteristics and Recurrence Patterns of High Grade Endometrioid Endometrial Cancer: A Large Retrospective Analysis of a Tertiary Center. Journal of clinical medicine, 12(9), 3141. https://doi.org/10.3390/jcm12093141 DOI: https://doi.org/10.3390/jcm12093141
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 The Publisher
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
Start-up >