Isolated vaginal recurrences of endometrial adenocarcinoma and their management

Eighteen patients with isolated vaginal recurrence of their previously treated endometrial carcinoma were treated with radiation therapy at North Carolina Baptist Hospital, Winston-Salem between 1971 and 1982. Most patients received external beam irradiation which were followed by boost treatments that were delivered with external beam (two patients) or intravaginal ovoid (11 patients). A local control rate of 44.4% with a 3-year minimum follow-up was obtained. Currently 33% are alive without evidence of disease 3 to 10 years following treatment. The most important prognostic indicator of outcome was size of vaginal recurrence. Of seven evaluable patients with tumors smaller than 2 cm there was one local failure. In contrast there were eight local failures in ten patients treated for tumors larger than 2 cm. Close follow-up and prompt diagnosis will enhance the chance of cure in endometrial cancer patients who do have recurrences.