Prognostic factors and sites of failure in figo Stage I, Grade 3 endometrial carcinoma

The present study was undertaken with the question about the outcome (recurrence-free survival, [RFS]) after adjuvant chemotherapy with taxane and carboplatin in the early stages of epithelial ovarian cancer after primary surgery. Treatment-related toxicity was also evaluated. A total of 113 patients were included in this study. The 5-year RFS rate for all 113 patients treated with adjuvant chemotherapy including taxane and carboplatin after primary surgery was 79%. The 5-year RFS rate for 85 patients in FIGO stage I was 85% and for 18 patients in FIGO stage II, it was 44%. For clear-cell carcinomas, the RFS was 87%. In univariate analysis, recurrent disease was associated with both FIGO stage and tumor grade, but in multivariate logistic regression analysis of prognostic factors for tumor recurrences, only FIGO stage (stage I versus stage II) was a significant and independent prognostic factor. However, an odds ratio (OR) of 1.9 for tumor grade (grade 3 versus grades 1–2) demonstrated two times increased risk for recurrence in a patient with a grade 3 tumor compared with grade 1–2 tumors. Furthermore, an OR of 0.39 for lymph node sampling versus no sampling meant 61% reduced risk for recurrence for a patient who had undergone lymph node sampling at surgical staging laparotomy. The major toxicities in the present study were myelosuppression (46%) and neurotoxicity (34%). Despite the use of prophylaxis, severe paclitaxel-related hypersensitivity occurred in three patients (3%)

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DNA ploidy status, S-phase fraction, and p53 are not independent prognostic factors for survival in endometrioid endometrial carcinoma FIGO stage I–III

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000082 ◽

2019 ◽

Vol 29 (2) ◽

pp. 305-311

Author(s):

Teresia Svanvik ◽

Ulf Strömberg ◽

Erik Holmberg ◽

Janusz Marcickiewicz ◽

Karin Sundfeldt

Keyword(s):

Prognostic Factors ◽

Endometrial Carcinoma ◽

Dna Ploidy ◽

Relative Survival ◽

Figo Stage ◽

S Phase ◽

Stage I ◽

Phase Fraction ◽

P53 Overexpression ◽

Endometrioid Endometrial Carcinoma

ObjectivesTo assess the effects on relative survival of established and new prognostic factors in stage I–III grade 1–3 endometrioid endometrial carcinoma and in the subgroup of stage I grade 1–2.MethodsThis was a population-based, retrospective study including all women (n=1113) in the western Swedish healthcare region diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I–III grade 1–3 endometrioid endometrial carcinoma in 2006–2011. Histology, grade, stage, and age were prospectively reported to the regional clinical and national cancer registers. DNA ploidy and S-phase fraction were analyzed by flow cytometer. S-phase fraction cut-off was set at ≥8%. Tumor biopsies were classified as diploid if there was one G0/G1 peak or the DNA index was 1.0±0.04. Overexpression of p53 as determined by immunohistochemistry was positive if strong nuclear staining was found in >30% of the neoplastic cells.ResultsBased on univariable statistical analyses we found that 5-year relative survival was significantly associated with S-phase fraction, DNA ploidy, p53, stage, grade, and age. Excess mortality for S-phase fraction ≥8%, aneuploidy, and p53 overexpression was 8, 14, and 8 and times higher, respectively. However, in a multivariable regression model, adjusted for stage, grade, and age, S-phase fraction, DNA ploidy, and p53 were not statistically independent prognostic factors (p=0.413, p=0.107, p=0.208, respectively) for 5-year relative survival in stage I–III grade 1–3 endometrioid endometrial carcinoma. In a subgroup analysis of stage I grade 1–2, aneuploidy identified a subgroup with impaired 5-year relative survival.ConclusionWe can conclude that S-phase fraction, DNA ploidy, and p53 overexpression did not improve identification of high-risk patients by stage, grade, and age in stage I–III endometrioid endometrial carcinoma. In stage I, aneuploidy and grade 2 predicted lower relative survival rates than other variables.

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Prognostic Factors of Stage I Endometrial Carcinoma Treated by Surgery

Endometrial Cancers ◽

10.1159/000412284 ◽

2015 ◽

pp. 75-81

Author(s):

M. Bolla

Keyword(s):

Prognostic Factors ◽

Endometrial Carcinoma ◽

Stage I

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Prognostic parameters in FIGO stage I endometrial carcinoma of endometrioid type

Vojnosanitetski pregled ◽

10.2298/vsp0612006s ◽

2006 ◽

Vol 63 (12) ◽

pp. 1006-1010 ◽

Cited By ~ 1

Author(s):

Zorica Stanojevic ◽

Biljana Djordjevic

Keyword(s):

Endometrial Carcinoma ◽

Myometrial Invasion ◽

Figo Stage ◽

Histologic Grade ◽

Stage I ◽

Prognostic Parameters ◽

Vascular Space ◽

Vascular Space Invasion ◽

Pathologic Parameters

Background/Aim. Endometrial carcinoma is the most common malignant neoplasm of the female genital tract in developed countries. Endometrioid carcinoma represents about three-fourths of all endometrial carcinoma. The aim of this study was to examine pathologic parameters, age, and the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type and to assess the prognostic utility of age, depth of myometrial invasion, hystologic type (endometrioid or variant), histologic grade, nuclear grade, and lymph-vascular space invasion. Methods. Age, pathologic parameters, and survival data were retrospectively collected on 236 patients with FIGO stage I endometrial carcinoma of endometrioid type. All the patients underwent hysterectomy between 1996 and 2000 and follow-up until December 2005. Results. A total of 236 patients (mean age 58.0, range 40?79) were analyzed. During the 5-year period of follow-up, 59 (25.0%) patents died from the disease. An univariate analysis revealed that age, depth of myometrial invasion, histologic grade, nuclear grade, and lymph-vascular space invasion were associated significantly with the 5-year survival of the patients. A multivariate analysis revealed that age, lymph-vascular space invasion, and depth of myometrial invasion were associated significantly with the 5-year survival. Conclusion. Age, lymph-vascular space invasion, and depth of myometrial invasion are independent prognostic parameters for the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type.

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Correlation of Ecadherin Expression in Endometrial Carcinoma with Tumour Grade and Stage

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v20i3.1737 ◽

2021 ◽

Vol 20 (3) ◽

Author(s):

Lizawati RH ◽

Nur Maya Sabrina TL ◽

Muhammad Fakhri MS ◽

Nordashima AS ◽

Azmawati MN

Keyword(s):

Lymph Node ◽

Endometrial Carcinoma ◽

Distant Metastasis ◽

Lymphovascular Invasion ◽

Myometrial Invasion ◽

Figo Stage ◽

Lymph Node Status ◽

Tumour Grade ◽

Grade 3 ◽

E Cadherin

INTRODUCTION: Endometrial carcinoma (EC) is among the common malignancy in the female with adverse prognosis in the advanced stage. Prediction of its prognosis is important in stratifying EC patients to achieve optimum treatment and improve clinical outcomes. This study is aimed to evaluate the prognostic significance of E-cadherin expression in patients with EC. The present study also investigated the correlation of E-cadherin expression in EC with its tumour grade and stage. MATERIALS AND METHODS: A total of 70 cases of EC were included in the study within eleven years comprising 56 cases of endometrioid carcinoma, 2 cases of mucinous carcinoma, 10 cases of serous carcinoma and 2 cases of clear cell carcinoma. E-cadherin expression was immunohistochemically analysed and compared with clinicopathological parameters. RESULTS: E-cadherin loss of expression shows significant association with non endometrioid EC (p=0.003), high tumour grade (p<0.001) and tumour with distant metastasis (p=0.028). Tumour grade is the main predictor of down-regulation of Ecadherin expression (Grade 3: aOR 8.400, 95%CI 2.534-27.842). There was no significant association found between E-cadherin expression with myometrial invasion, FIGO stage, lymph node status and lymphovascular invasion. CONCLUSION: E-cadherin loss of expression correlates with poor prognostic factors namely high grade and high stage (metastasis) EC. This may serve as a potential prognostic marker for EC>< 0.001) and tumour with distant metastasis (p=0.028). Tumour grade is the main predictor of down-regulation of E-cadherin expression (Grade 3: aOR 8.400, 95%CI 2.534-27.842). There was no significant association found between E-cadherin expression with myometrial invasion, FIGO stage, lymph node status and lymphovascular invasion.

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Prognostic Factors in Early-Stage Leiomyosarcoma of the Uterus

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181a1bfbc ◽

2009 ◽

Vol 19 (3) ◽

pp. 385-390 ◽

Cited By ~ 40

Author(s):

Manuela Pelmus ◽

Frédérique Penault-Llorca ◽

Louis Guillou ◽

Françoise Collin ◽

Gérard Bertrand ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Vascular Invasion ◽

Early Stage ◽

Prognostic Significance ◽

Figo Stage ◽

Stage I ◽

Free Interval ◽

Important Prognostic Factor ◽

Pathologic Features

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 × 10−15). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.

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