The impact of age and stage on the competing risk of cancer-related and non-cancer death in low- or high-grade endometrioid endometrial carcinoma and uterine serous carcinoma

2021 ◽  
Vol 162 ◽  
pp. S293-S294
Author(s):  
Cassandra Presti ◽  
Chunqiao Tian ◽  
Emma Robinson ◽  
Tahimi Gonzalez ◽  
Chad Hamilton ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Competing Risk ◽  
Serous Carcinoma ◽  
High Grade ◽  
Cancer Death ◽  
Uterine Serous Carcinoma ◽  
Endometrioid Endometrial Carcinoma ◽  
Risk Of Cancer ◽  
The Impact

scholarly journals Competing Risks of Cancer and Non-Cancer Mortality When Accompanied by Lifestyle-Related Factors—A Prospective Cohort Study in Middle-Aged and Older Adults

2020 ◽  
Vol 10 ◽  
Author(s):  
Pawel Macek ◽  
Malgorzata Biskup ◽  
Malgorzata Terek-Derszniak ◽  
Marta Manczuk ◽  
Halina Krol ◽  
...  
Keyword(s):  
Cancer Mortality ◽  
Vigorous Physical Activity ◽  
Competing Risk ◽  
Cancer Death ◽  
Related Factors ◽  
Risk Of Death ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Risk Of Cancer ◽  
The Impact

BackgroundThe study aimed to identify the association between the lifestyle-related factors and the cancer-specific, or non-cancer-specific mortality, when accompanied by a competing risk. Two statistical methods were applied, i.e., cause-specific hazard (CSH), and sub-distribution hazard ratio (SHR). Their respective key advantages, relative to the actual study design, were addressed, as was overall application potential.MethodsSource data from 4,584 residents (34.2% men), aged 45–64 years, were processed using two different families of regression models, i.e., CSH and SHR; principal focus upon the impact of lifestyle-related factors on the competing risk of cancer and non-cancer mortality. The results were presented as hazard ratios (HR) with 95% confidence intervals (95% CI).ResultsAge, smoking status, and family history of cancer were found the leading risk factors for cancer death; the risk of non-cancer death higher in the elderly, and smoking individuals. Non-cancer mortality was strongly associated with obesity and hypertension. Moderate to vigorous physical activity decreased the risk of death caused by cancer and non-cancer causes.ConclusionsSpecific, lifestyle-related factors, instrumental in increasing overall, and cancer-specific mortality, are modifiable through health-promoting, individually pursued physical activities. Regular monitoring of such health-awareness boosting pursuits seems viable in terms of public health policy making.

scholarly journals Updated evaluation of clinicopathologic landscape in histopathologic subtypes of endometrial carcinoma with MMR gene mutation

2020 ◽  
Author(s):  
Aifen Wang ◽  
Weidong Hu ◽  
Qingfu Zhang ◽  
Hongjiu Ren ◽  
Ziyue Zhang ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Gene Mutation ◽  
Gene Mutations ◽  
Molecular Data ◽  
The Cancer Genome Atlas ◽  
Serous Carcinoma ◽  
Histologic Subtype ◽  
Uterine Serous Carcinoma ◽  
Endometrioid Endometrial Carcinoma ◽  
Grade 3

Abstract Objective: This study aimed to identify an optimal screening strategy to detect mismatch repair (MMR) mutation for each histologic subtype of endometrial carcinoma. Material and methods: We performed a comparative analysis of the demographic, clinical, pathologic, and molecular data for 562 patients from The Cancer Genome Atlas database, stratified by tumor histologic subtype.Results: Molecular data, including MLH1, MLH3, PMS1, PMS2, MSH2, MSH3, MSH6, and EPCAM, was available for 562 patients, of which 162 (28.8%) had tumors that were positive for MMR gene mutations. Of these tumors, the penetrate rate of grade 3 endometrioid endometrial carcinoma (84/184, 45.7%) was significantly higher than that of uterine serous carcinoma (35/156, 22.4%) (p < 0.001), grade 2 endometrioid endometrial carcinoma (26/129, 20.2%) (p < 0.001), and grade 1 endometrioid endometrial carcinoma (17/93, 18.3%) (p < 0.001). Of 562 endometrial carcinomas, alterations in MSH2 (n = 55), MSH6 (n = 54), and MSH3 (n = 50) were the most frequent mutations. There were no differences in overall survival and progression-free interval (PFI) between MMR mutation carriers and nonmutation carriers (p >0.05) except that PFI with MMR gene mutation was higher than with MMR proficiency in grade 3 endometrioid endometrial carcinoma (p = 0.014). Conclusions: Grade 3 endometrioid endometrial carcinoma harbored more MMR mutations than grade 1 endometrioid endometrial carcinoma, grade 2 endometrioid endometrial carcinoma, and uterine serous carcinoma. Besides MLH1, MSH2, MSH6, PMS2, and EPCAM mutation, MLH3, MSH3, and PMS1 mutation may be necessary to be screened in patients with newly diagnosed endometrial carcinoma.

scholarly journals Updated evaluation of clinicopathologic landscape in histopathologic subtypes of endometrial carcinoma with MMR gene mutation

2020 ◽  
Author(s):  
Aifen Wang ◽  
Weidong Hu ◽  
Qinfu Zhang ◽  
Hongjiu Ren ◽  
Zihan Zhao ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Gene Mutation ◽  
Gene Mutations ◽  
Molecular Data ◽  
The Cancer Genome Atlas ◽  
Serous Carcinoma ◽  
Histologic Subtype ◽  
Uterine Serous Carcinoma ◽  
Endometrioid Endometrial Carcinoma ◽  
Grade 3

Abstract Background: This study aimed to identify an optimal screening strategy to detect mismatch repair (MMR) mutation for each histologic subtype of endometrial carcinoma. Methods:We performed a comparative analysis of the demographic, clinical, pathologic, and molecular data for 562 patients from The Cancer Genome Atlas database, stratified by tumor histologic subtype.Results: Molecular data, including MLH1, MLH3, PMS1, PMS2, MSH2, MSH3, MSH6, and EPCAM, was available for 562 patients, of which 162 (28.8%) had tumors that were positive for MMR gene mutations. Of these tumors, the penetrate rate of grade 3 endometrioid endometrial carcinoma (84/184, 45.7%) was significantly higher than that of uterine serous carcinoma (35/156, 22.4%) (p < 0.001), grade 2 endometrioid endometrial carcinoma (26/129, 20.2%) (p < 0.001), and grade 1 endometrioid endometrial carcinoma (17/93, 18.3%) (p < 0.001). Of 562 endometrial carcinomas, alterations in MSH2 (n = 55), MSH6 (n = 54), and MSH3 (n = 50) were the most frequent mutations. There were no differences in overall survival and progression-free interval (PFI) between MMR mutation carriers and nonmutation carriers (p >0.05) except that PFI with MMR gene mutation was higher than with MMR proficiency in grade 3 endometrioid endometrial carcinoma (p = 0.014). Conclusions: Grade 3 endometrioid endometrial carcinoma harbored more MMR mutations than grade 1 endometrioid endometrial carcinoma, grade 2 endometrioid endometrial carcinoma, and uterine serous carcinoma. Besides MLH1, MSH2, MSH6, PMS2, and EPCAM mutation, MLH3, MSH3, and PMS1 mutation may be necessary to be screened in patients with newly diagnosed endometrial carcinoma.

scholarly journals Comparison of Survival Benefits of Combined Chemotherapy and Radiotherapy Versus Chemotherapy Alone for Uterine Serous Carcinoma: A Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Yanying Lin ◽  
Jingyi Zhou ◽  
Yuan Cheng ◽  
Lijun Zhao ◽  
Yuan Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Publication Bias ◽  
Meta Analysis ◽  
Serous Carcinoma ◽  
Cochrane Library ◽  
Combined Chemotherapy ◽  
Risk Of Death ◽  
Stage Disease ◽  
Uterine Serous Carcinoma ◽  
The Impact

ObjectiveTo date, there is no convincing evidence comparing the impact of combined chemotherapy and radiotherapy with chemotherapy alone in postoperative uterine serous carcinoma (USC), which remains an unclear issue. We conducted a meta-analysis assessing the impact of combined chemotherapy and radiotherapy compared to chemotherapy alone on overall survival in postoperative USC.MethodsA comprehensive search was performed in the databases of EMBASE, PubMed, Web of Science, and Cochrane Library from inception to March 2016. Studies comparing survival among patients who underwent combined chemotherapy and radiotherapy or chemotherapy alone after surgery for USC were included. Quality assessments were carried out by the Newcastle–Ottawa Scale. Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. Publication bias was assessed using both funnel plot and the Egger regression test. Statistical analyses were performed using Stata version 13.0 software.ResultNine retrospective studies with relatively high quality containing 9354 patients were included for the final meta-analysis. The pooled results demonstrated that combined chemotherapy and radiotherapy significantly reduced the risk of death (HR, 0.72; P < 0.0001) compared to chemotherapy alone with a low heterogeneity (I2 = 21.0%, P = 0.256). Subgroup analyses indicated that calculating HR by unadjusted method may cause the heterogeneity among studies. Exploratory analyses showed that either patients with early stage disease (HR, 0.73; P = 0.011) or advanced stage disease (HR, 0.80; P < 0.0001) have survival benefits from combined chemotherapy and radiotherapy. No significant evidence of publication bias was found.ConclusionsThis is the first meta-analysis examining the role of combined chemotherapy and radiotherapy compared to chemotherapy alone in USC. Our results suggest the potential survival benefits of combined chemotherapy and radiotherapy. Further studies, preferably randomized clinical trials, are needed to confirm our results.

Immunohistochemical Overexpression of p16 and p53 in Uterine Serous Carcinoma and Ovarian High-grade Serous Carcinoma

2007 ◽  
Vol 26 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Andres G. Chiesa-Vottero ◽  
Anais Malpica ◽  
Michael T. Deavers ◽  
Russell Broaddus ◽  
Gerard J. Nuovo ◽  
...  
Keyword(s):  
Serous Carcinoma ◽  
High Grade ◽  
Uterine Serous Carcinoma

Trends in Treatment of Uterine Serous Cancer in the Medicare Population

2015 ◽  
Vol 25 (6) ◽  
pp. 1023-1030 ◽  
Author(s):  
Jose Alejandro Rauh-Hain ◽  
Sarah C. Connor ◽  
Joel T. Clemmer ◽  
Olivia W. Foley ◽  
Rachel M. Clark ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Serous Carcinoma ◽  
Medicare Population ◽  
Study Population ◽  
Uterine Serous Carcinoma ◽  
The Impact ◽  
Over Time

ObjectiveThe objectives of this study were to evaluate the rates of chemotherapy and radiotherapy delivery in the treatment of uterine serous carcinoma in the Medicare population and to compare clinical outcomes in treated and untreated patients.MethodsThe linked Surveillance, Epidemiology, and End Results and Medicare databases were queried to identify patients with a diagnosis of uterine serous carcinoma between 1992 and 2009. The impact of chemotherapy on survival was analyzed using the Kaplan-Meier method. Factors predictive of outcome were compared using the Cox proportional hazards model.ResultsA total of 2188 patients met study eligibility criteria. Stages I, II, III, and IV diseases accounted for 890 (41%), 174 (8%), 470 (21%), and 654 (30%) of the study population, respectively. Chemotherapy, radiotherapy, both, or none, were administered as adjuvant therapy in 635 (29%), 536 (24%), 308 (14%), and 709 (32%) of the study population, respectively. Use of chemotherapy became more frequent over time. Over the study period, and after adjusting for race, time of diagnosis, SEER registry, marital status, stage, age, surgery, lymph node dissection, socioeconomic status, and comorbidity index, there was an association between receipt of radiotherapy alone (hazard ratio [HR], 1.3; 95% CI, 1.04–1.67) and not receiving any treatment (HR, 1.5; 95% CI, 1.2–2.01) and worst survival. Survival was not improved over time.ConclusionAlthough adjuvant chemotherapy and combination treatment with chemotherapy and radiation were associated with improved survival in our model, there was no significant improvement in survival over time.

scholarly journals Adjuvant treatment for patients with FIGO stage I uterine serous carcinoma confined to the endometrium

2020 ◽  
Vol 30 (8) ◽  
pp. 1089-1094 ◽  
Author(s):  
Dimitrios Nasioudis ◽  
Allison Grace Roy ◽  
Emily M Ko ◽  
Lori Cory ◽  
Robert L Giuntoli II ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Myometrial Invasion ◽  
Stage I ◽  
Serous Carcinoma ◽  
Rank Test ◽  
Survival Difference ◽  
Uterine Serous Carcinoma ◽  
The Impact

ObjectivesThe role of adjuvant treatment for early-stage uterine serous carcinoma is not defined. The goal of this study was to investigate the impact of adjuvant treatment on survival of patients with tumors confined to the endometrium.MethodsPatients diagnosed with stage I uterine serous carcinoma with no myometrial invasion between January 2004 and December 2015 who underwent hysterectomy with at least 10 lymph nodes removed were identified from the National Cancer Database. Adjuvant treatment patterns defined as receipt of chemotherapy and/or radiotherapy within 6 months from surgery were investigated and overall survival was evaluated using Kaplan–Meier curves, and compared with the log-rank test for patients with at least one month of follow-up. A Cox analysis was performed to control for confounders.ResultsA total of 1709 patients were identified; 833 (48.7%) did not receive adjuvant treatment, 348 (20.4%) received both chemotherapy and radiotherapy, 353 (20.7%) received chemotherapy only, and 175 (10.2%) received radiotherapy only. Five-year overall survival rates for patients who did not receive adjuvant treatment (n=736) was 81.9%, compared with 91.3% for those who had chemoradiation (n=293), 85.1% for those who received radiotherapy only (n=143), and 91.0% for those who received chemotherapy only (n=298) (p<0.001). After controlling for age, insurance status, type of treatment facility, tumor size, co-morbidities, and history of another tumor, patients who received adjuvant chemotherapy (HR 0.64, 95% CI 0.42, 0.96), or chemoradiation (HR 0.55, 95% CI 0.35, 0.88) had better survival compared with those who did not receive any adjuvant treatment, while there was no benefit from radiotherapy alone (HR 0.85, 95% CI 0.53, 1.37). There was no survival difference between chemoradiation and chemotherapy only (HR 1.15, 95% CI 0.65, 2.01).ConclusionAdjuvant chemotherapy (with or without radiotherapy) is associated with a survival benefit for uterine serous carcinoma confined to the endometrium.

scholarly journals Could Obesity be a Triggering Factor for Endometrial Tubal Metaplasia to be a Precancerous Lesion?

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Ayman M. El-Saka ◽  
Yomna A. Zamzam ◽  
Yosra A. Zamzam ◽  
Ayman El-Dorf
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
High Serum ◽  
Estradiol Level ◽  
Serous Carcinoma ◽  
Serum Estradiol ◽  
Serum Estradiol Level ◽  
Group 3 ◽  
The Impact ◽  
Group 1

Background & Aims. Endometrial tubal metaplasia (ETM) is mostly described in conjunction with unopposed estrogen levels, and its association with endometrial hyperplasia and endometrial carcinoma (EC) is striking. Obesity is a risk factor for endometrial hyperplasia and EC development. The aim of this study is to investigate the impact of BMI and serum estradiol level on expression of PAX-2, H-TERT, P16, Ki-67, and P53 in studied ETM in reference to benign endometrium and EC. Methods. The study was conducted on the following groups: group (1) consists of 57 cases that had endometrial biopsies with histologically demonstrable ETM (typical or atypical) and all were subjected to serum estradiol levelling and body mass index (BMI) evaluation; group (2) had adjacent benign endometrial tissue as control; group (3) consists of 52 cases of conventional endometrial carcinoma and 16 serous carcinoma paraffin blocks which were collected and reevaluated. All included groups were immunostained for PAX-2, H-TERT, p16, ki67, and p53. Results. The relation between BMI and serum estradiol level in group 1 and PAX-2, H-TERT, P16, and p53 was statistically significant, while their relation with atypia and ki67 expression was insignificant. Twenty-three ETM cases (40.4%) out of group 1 were all (100%) obese, 87% had high serum estradiol level, and 73.9% were postmenopausal and had a similar immunohistochemical profile as EC cases (group 3). Conclusions. The presence of ETM regardless of the histologic atypia in obese postmenopausal patients with high serum estradiol level is an alarming sign. This implies that ETM might not be as benign as generally accepted, as under certain clinical conditions, it may turn into a potential premalignant lesion.

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