Clinicopathologic features of bone metastases and outcomes in patients with primary endometrial cancer

Objective: Patients with advanced or recurrent endometrial cancer often have distant metastases found within the lymph nodes, liver, and/or lung. However, there have been reported cases of primary endometrial cancer with metastasis to the bone. The objective of this study was to describe the clinical and pathologic features of endometrial cancer metastatic to bone. Methods: A retrospective chart review of our clinical and pathology database was performed to identify women diagnosed with endometrial cancer metastatic to the bone between 1990 and 2007. Clinical data and outcomes were obtained from medical records. Slides were re-reviewed to confirm the diagnosis. Results: Twenty-one patients with endometrial cancer metastatic to the bone were identified; in 12 patients (57%), the diagnosis was confirmed by a bone biopsy. The median age of diagnosis of primary endometrial cancer was 60 years (range, 32-84). Fourteen patients (67%) had FIGO stage III/IV disease. Six patients (29%) had a bone metastasis at the time of diagnosis while 15 patients (71%) had a bone lesion as a recurrence. The median time to a diagnosis of bone metastasis recurrence was 10 months (range, 3-148). The overall survival of those patients with bone metastases at primary diagnosis was 17 months (95% CI: 2-32) compared to 32 months (95% CI: 14-49) for those with a recurrent bone metastasis. Conclusion: Although a rare event, endometrial cancer can metastasize to the bone. If a bone lesion is identified, treatment using a multimodality approach is reasonable, especially if found as an isolated recurrence.