{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:52:56Z","timestamp":1782478376860,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","award":["2019XK320046"],"award-info":[{"award-number":["2019XK320046"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to evaluate site\u2010specific recurrent patterns via competing risks analysis and hazard function to provide evidence for adjuvant treatment and follow\u2010up for early staged endometrial cancer (EC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 858 patients with International Federation of Gynecology and Obstetrics stage I\u2013II EC who received\u00a0adjuvant radiotherapy at our institution (2000\u20132017) were included. The radiotherapy modality comprised external beam radiotherapy (EBRT) with or without vaginal brachytherapy (VBT) or VBT alone. Competing risks analysis and hazard rate function were employed to evaluate the recurrence rate according to the ESMO\u2013ESGO\u2013ESTRO risk classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 5\u2010year overall survival rates of the low\u2010risk (LR), intermediate\u2010risk (IR), high\u2013intermediate risk (HIR), and high\u2010risk (HR) groups were 96.1%, 95%, 93%, and 89.7%, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.018). Sixty\u2010eight patients developed recurrence. The 5\u2010year incidence of distant recurrence was the highest in the HR group (14.87%), followed by the HIR (7.71%), IR (5.27%), and LR (1.26%) groups (Gray's test, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The LR and IR groups showed late metastasis behaviors for distant metastasis. The HR group presented a large magnitude of distant metastasis with an early peak that increased beyond 3\u00a0years. Subgroup analysis revealed that EBRT\u00b1VBT tended to reduce the locoregional relapse rate compared with VBT in the HIR\u2013HR group (2.36% vs. 7.73%, Gray's test, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The established competing risk modeling demonstrated different recurrence patterns across the risk groups and radiotherapy modes. A better understanding of the change in site\u2010specific recurrence behavior allows more targeted adjuvant treatment and surveillance regimens.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4423","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T10:16:20Z","timestamp":1636971380000},"page":"257-267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Recurrent patterns after postoperative radiotherapy for early stage endometrial cancer: A competing risk analysis model"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-6372","authenticated-orcid":false,"given":"Kang","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7521-9953","authenticated-orcid":false,"given":"Wenhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorong","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuquan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Science &amp; Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2018.1491311"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.04.676"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-8258(03)00126-4"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2020.31.e39"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.02.011"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2020-002230"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.10.025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.09.023"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2017.08.004"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.03.047"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1985.3.10.1418"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv484"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705727"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26378"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56090468"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2018.07.053"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62163-2"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3864-6"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.03.203"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs374"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-018-2711-8"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv462"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncponc0999"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00549"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.190"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-2878"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-019-0825-z"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0006"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61767-5"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.09.017"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2014.01.003"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.46.1574"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.4423","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.4423","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.4423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T16:48:40Z","timestamp":1693241320000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.4423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,15]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/cam4.4423"],"URL":"https:\/\/doi.org\/10.1002\/cam4.4423","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,15]]},"assertion":[{"value":"2021-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}