Recurrence Rates of Endometrial Cancer by Stage and Risk Factors

Recurrence Rates by Stage

The National Comprehensive Cancer Network recommends that overall recurrence rates of endometrial cancer are approximately 15% for clinical stage I and II disease, with most recurrences occurring within the first 3 years after treatment 1
For Stage IA (invasion <50% of myometrium), the 5-year survival rate is 89.6% with a corresponding recurrence risk of approximately 10.4% 2
For Stage IB (invasion ≥50% of myometrium), the 5-year survival rate is 77.6% with a corresponding recurrence risk of approximately 22.4% 2
Stage II contributes to the overall 15% recurrence rate for early-stage disease 1
Stage IIIC1 (positive pelvic nodes) has a 5-year survival rate of 57%, indicating a recurrence risk of approximately 43% 2
Stage IIIC2 (positive para-aortic nodes) has a 5-year survival rate of 49%, indicating a recurrence risk of approximately 51% 2
Stage IV has the highest recurrence rates, with 5-year survival rates significantly lower than earlier stages 4

The European Society of Medical Oncology states that low-risk endometrial cancer, such as Stage IA (G1-G2) with endometrioid type, has low recurrence rates 5
Intermediate-risk endometrial cancer, such as Stage IA G3 with endometrioid type, has moderate recurrence rates, higher than low-risk but lower than high-risk 5
High-intermediate risk endometrial cancer, such as Stage I endometrioid type with substantial LVSI, has higher recurrence rates than intermediate-risk 5
High-risk endometrial cancer, such as all stages with p53-abnormal tumors and myometrial invasion, has the highest recurrence rates among all risk categories 5

Histological type is a significant risk factor, with 5-year survival rates varying significantly - endometrioid (83%) vs. clear cell (62%) vs. papillary serous (53%) 2
Lymphovascular space invasion (LVSI) is a significant risk factor, with 5-year overall survival of 64% with LVSI vs. 88% without LVSI 2
Molecular classification significantly impacts recurrence risk, with p53-abnormal, POLEmut, dMMR, and NSMP subgroups having different prognoses 5

Most recurrences occur within the first 3 years after treatment, justifying intensive surveillance during this period 2
Approximately 50-70% of recurrences are symptomatic 1