Ouldamer L, et al. - Researchers assessed the metastatic patterns and the possible distribution of metastatic disease in endometrial cancer (EC). From 1,444 women with EC, they identified 110 women who developed distant metastatic disease with (n = 37 [33.6%]) or without (n = 73[66.4%]) locoregional recurrence, including 39 women with exclusive first site of metastatic disease and 34 women with multiple sites of metastatic disease. Lung was identified to be the most common exclusive first site of metastasis (42.8%) when all women were considered. Following the conclusion of treatment for exclusive brain metastatic disease, they observed shorter median time to develop distant metastases vs other sites of metastatic disease (7 months vs 9 for lung, 10 for liver, 19 for bone and 27 months for sus-diaphragmatic LN). The sus-diaphragmatic LN metastase group had higher rate of 3-year overall survival (83.3% vs 50.6% for lung, 37.3% for bone, 16.7% for brain and 0% for liver). The current clinical practice of screening for site-specific metastatic disease following initial treatment of early stage EC based on worrisome women-specific signs or symptoms is supported.