Analysis Of Stage IIIB Endometrioid Type Endometrium Cancer: Experince Of Two Tertiary Oncology Center

Abstract

Aim: The objective of this study was to analyzestage IIIB endometrioid type endometrial cancer.Material and Methods: This study was conducted in two gynecologic oncology centers between January 2007 and December 2016. Endometrial cancer was staged according to the International Federation of Gynecology and Obstetrics FIGO staging system and stage IIIB endometrioid type endometrial cancer patients were included in the study.The clinicopathologic findings of the patients were analyzed by reaching through the hospital database.Result: A total of 1700 endometrial cancer patients were investigated and of these patients, 10 were diagnosed with stage IIIB endometrioid type endometrial cancer. The median age of the patients were 62 years 49-85 and the median follow-upwas 45 months 20-93 . Four and four patients were diagnosed with vaginal involvement andparametrial involvement, respectively. Two patients were diagnosed withboth vaginal and parametrial involvement. Six 60% patients underwent radical hysterectomy and 4 40% patients underwent simple hysterectomy. Six patients received adjuvan chemotherapy. Only one patient received adjuvan pelvic radiotherapy whereas 3 patients received adjuvan vaginal brakitherapydue to advanced age. There were four recurrent cases.The five-year disease-freesurvival DFS rate and overall survival OS rate was 50% and 66.7%, respectively.Conclusion: Stage IIIB endometroid type endometrium cancer represents a rare specific subgroup of endometroid type endometrium cancer. As our knowledge this is the only study in the national literature. There is need for multi-center studies involving large number of patients.

Keywords

• Endometrial cancer,stage IIIB,survival

Evre IIIB Endometrioid Tip Endometrium Kanser Olgularının Analizi: Tersiyer İki Onkolojik Merkez Deneyimi

Abstract

Giriş: Bu çalışmanın amacı Evre IIIB endometrioid tip endometrium kanseri tanısı konulan olguları analiz etmektir.Gereç ve Yöntemler: Bu çalışma Ocak 2007-Aralık 2016 yılları arasında Uluslararası Obstetri ve Jinekoloji Federasyonu FIGO kriterlerine göre evre IIIB tanısı konulan hastaların dahil edildiği retrospektif iki merkezli bir çalışmadır. Olguların klinikopatolojik özellikleri kaydedilerek analiz edildi.Bulgular: Toplam 1700 endometrioid tip endometrium incelenmiş olup evre IIIB tanısı konulan 10 % 0,6 hasta tespit edildi. Olguların ortanca yaşı 62 49-85 , ortanca takip süresi ise 45 20-93 ay tespit edildi. Dört olguda vajinal, 4 olguda parametrium ve 2 olguda ise hem vajinal hem parametrial tutulum izlendi. Altı %60 olguya radikal histerektomi, 4 %40 olguya basit histerektomi yapıldı. Altı olguya adjuvan tedavi olarak kemoradyoterapi, 1 olguya sadece pelvik radyoterapi, yaşı ileri olan 3 olguya ise sadece vajinal brakiterapi verildi. Dört olguda nüks meydana geldi. Olguların 5 yıllık hastalıksız sağkalım DFS ve genel sağkalım OS oranı sıra ile %50 ve %66,7 olarak bulundu.Sonuç: Evre IIIB endometrioid tip endometrium kanseri nadir bir spesifik alt grubu temsil etmektedir. Bu çalışma ulusal literatürdeki tek çalışmadır. Daha geniş serili ve çok merkezli çalışmalara ihtiyaç vardır.

Keywords

• Endometrial kanser,evre IIIB,sağkalım

References

1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017 Jan;67(1):7-30.
2. Lewin SN. Revised FIGO staging system for endometrial cancer. Clin Obs- tet Gynecol 2011 Jun;54(2):215-8.
3. Barth JA. [Revised FIGO staging for corpus and vulvar carcinoma]. Zent- ralbl Gynakol 1990;112(22):1437.
4. Ueda SM, Kapp DS, Cheung MK, Shin JY, Osann K, Husain A, et al. Tren- ds in demographic and clinical characteristics in women diagnosed with corpus cancer and their potential impact on the increasing number of deaths. Am J Obstet Gynecol 2008 Feb;198(2):218 e1-6.
5. Smith RS, Kapp DS, Chen Q, Teng NN. Treatment of high-risk uterine cancer with whole abdominopelvic radiation therapy. Int J Radiat Oncol Biol Phys 2000 Oct 1;48(3):767-78.
6. Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, et al. Randomized phase III trial of whole-abdominal irradiation versus doxoru- bicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol 2006 Jan 1;24(1):36- 44.
7. Onda T, Yoshikawa H, Mizutani K, Mishima M, Yokota H, Nagano H, et al. Treatment of node-positive endometrial cancer with comple- te node dissection, chemotherapy and radiation therapy. Br J Cancer 1997;75(12):1836-41.
8. Nicklin JL, Petersen RW. Stage 3B adenocarcinoma of the endometrium: a clinicopathologic study. Gynecol Oncol 2000 Aug;78(2):203-7.

9. Mehta N, Yamada SD, Rotmensch J, Mundt AJ. Outcome and pattern of failure in pathologic stage I-II papillary serous carcinoma of the endomet- rium: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys 2003 Nov 15;57(4):1004-9.
10. Sari ME, Meydanli MM, Turkmen O, Comert GK, Turan AT, Karalok A, et al. Prognostic factors and treatment outcomes in surgically-staged non-invasive uterine clear cell carcinoma: a Turkish Gynecologic Onco- logy Group study. J Gynecol Oncol 2017 Jul;28(4):e49.
11. Mundt AJ, McBride R, Rotmensch J, Waggoner SE, Yamada SD, Connell PP. Significant pelvic recurrence in high-risk pathologic stage I--IV endo- metrial carcinoma patients after adjuvant chemotherapy alone: implicati- ons for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys 2001 Aug 1;50(5):1145-53.
12. Pecorelli S, Favalli G, Zigliani L, Odicino F. Cancer in women. Int J Gynae- col Obstet 2003 Sep;82(3):369-79.
13. Ayhan A, Taskiran C, Celik C, Aksu T, Yuce K. Surgical stage III endometri- al cancer: analysis of treatment outcomes, prognostic factors and failure patterns. Eur J Gynaecol Oncol 2002;23(6):553-6.
14. Kuku S, Williams M, McCormack M. Adjuvant therapy in stage III en- dometrial cancer: treatment outcomes and survival. a single-institution retrospective study. Int J Gynecol Cancer 2013 Jul;23(6):1056-64.
15. van Wijk FH, van der Burg ME, Burger CW, Vergote I, van Doorn HC. Management of surgical stage III and IV endometrioid endometrial carci- noma: an overview. Int J Gynecol Cancer 2009 Apr;19(3):431-46.
16. Alvarez Secord A, Havrilesky LJ, Bae-Jump V, Chin J, Calingaert B, Bland A, et al. The role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer. Gynecol Oncol 2007 Nov;107(2):285-91.
17. Benedet JL, Bender H, Jones H, 3rd, Ngan HY, Pecorelli S. FIGO sta- ging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 2000 Aug;70(2):209-62.
18. Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, tre- atment and follow-up. Ann Oncol 2013 Oct;24 Suppl 6:vi33-8.
19. Secord AA, Havrilesky LJ, O'Malley DM, Bae-Jump V, Fleming ND, Bro- adwater G, et al. A multicenter evaluation of sequential multimodality therapy and clinical outcome for the treatment of advanced endometrial cancer. Gynecol Oncol 2009 Sep;114(3):442-7.
20. Galaal K, Al Moundhri M, Bryant A, Lopes AD, Lawrie TA. Adjuvant che- motherapy for advanced endometrial cancer. Cochrane Database Syst Rev 2014 May 15(5):CD010681.