Long-term Survival Outcomes of Early-stage Grade 1 and 2 EndometrioidType Endometrial Cancer Patients
Öz
Aims: Early-stage endometrioid-type endometrial cancer (EC) has a favorable prognosis. The recurrence is still the biggest issue. There are differences in the literature in terms of treatment modalities in early-stage. We investigated long-term survival outcomes of early-stage grade 1 and 2 endometrioid-type EC patients.
Methods: Out of 327 cases, 294 cases in stage 1 and 33 cases in stage 2 were evaluated. Age, stage, tumor size, histologic grade, degree of myometrial invasion, presence of lymphovascular invasion (LVSI), peritoneal cytology positive, presence of recurrence, overall survival (OS), and disease-free survival (DFS) between two groups were evaluated statistically.
Results: The mean age of 327 patients was 64.0±10.0 years. Out of 327, 65.7% were ≥60 years, 90% were stage 1, 74.6% were grade 1, 1.8% had positive peritoneal cytology, 8.3% had LVSI and 86% had ≤50% myometrial invasion. Recurrence was detected in 6.4% of patients. 40.7% of patients received adjuvant radiotherapy. Only the adjuvant radiotherapy was found a significant association between two groups. Only presence of recurrence in terms of OS and DFS durations was a significant parameter in the regression analysis.
Conclusions: Development of recurrence in early-stage endometrioid-type EC is the main prognostic predictor for survival. The early diagnosis and treatment of recurrence have a positive impact on the prognosis.
Anahtar Kelimeler
endometrial cancer, endometrioid type, recurrence, survival
Destekleyen Kurum
None
Proje Numarası
None
Teşekkür
None
Kaynakça
- Siegel RL MK, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020 Jan;70(1):7-30. .
- Tung HJ, Huang HJ, Lai CH. Adjuvant and post-surgical treatment in endometrial cancer. Best Pract Res Clin Obstet Gynaecol. 2022 Jan;78:52-63.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
- McDonald ME, Bender DP. Endometrial Cancer: Obesity, Genetics, and Targeted Agents. Obstet Gynecol Clin North Am. 2019 Mar;46(1):89-105. .
- Creasman WT, Odicino F, Maisonneuve P, Quinn MA, Beller U, Benedet JL et al. Carcinoma of the corpus uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006 Nov;95 Suppl 1:S105-43. .
- Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C et al. ESMO Guidelines Working Group. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24 Suppl 6:vi33-8. .
- Connor EV, Rose PG. Management Strategies for Recurrent Endometrial Cancer. Expert Rev Anticancer Ther. 2018 Sep;18(9):873-885. .
- Scholten AN, van Putten WL, Beerman H, Smit VT, Koper PC, Lybeert ML et al. PORTEC Study Group. Postoperative radiotherapy for Stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review. Int J Radiat Oncol Biol Phys. 2005 Nov 1;63(3):834-8. .
- Nugent EK, Bishop EA, Mathews CA, Moxley KM, Tenney M, Mannel RS et al. Do uterine risk factors or lymph node metastasis more significantly affect recurrence in patients with endometrioid adenocarcinoma? Gynecol Oncol. 2012 Apr;125(1):94-8. .
- Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD et al. Gynecologic Oncology Group. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004 Mar;92(3):744-51. .