Which patients with stage IB endometrioid endometrial cancer are at high risk of distant recurrences?

2021 ◽  
Vol 162 ◽  
pp. S335
Author(s):  
Giorgia Dinoi ◽  
Simone Garzon ◽  
Gretchen Glaser ◽  
Amanika Kumar ◽  
Carrie Langstraat ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Stage Ib ◽  
Endometrioid Endometrial Cancer

Lymphadenectomy in Early-Stage Intermediate-/High-Risk Endometrioid Endometrial Cancer: Clinical Characteristics and Outcomes in an Australian Cohort

2017 ◽  
Vol 27 (7) ◽  
pp. 1379-1386 ◽  
Author(s):  
Rhonda Farrell ◽  
Suzanne C. Dixon ◽  
Jonathan Carter ◽  
Penny M. Webb
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Treatment ◽  
Cox Regression ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Cancer Study ◽  
Stage Ib ◽  
Australian Cohort

ObjectiveThe role of lymphadenectomy (LND) in early-stage endometrial cancer (EC) remains controversial. Previous studies have included low-risk patients and nonendometrioid histologies for which LND may not be beneficial, whereas long-term morbidity after LND is unclear. In a large Australian cohort of women with clinical early-stage intermediate-/high-risk endometrioid EC, we analyzed the association of LND with clinicopathological characteristics, adjuvant treatment, survival, patterns of disease recurrence, and morbidity.Materials and MethodsFrom a larger prospective study (Australian National Endometrial Cancer Study), we analyzed data from 328 women with stage IA grade 3 (n = 63), stage IB grade 1 to 3 (n = 160), stage II grade 1 to 3 (n = 71), and stage IIIC1/2 grade 1 to 3 (n = 31/3) endometrioid EC. Overall survival (OS) was estimated using Kaplan-Meier methods. The association of LND with OS was assessed using Cox regression analysis adjusted for age, stage, grade, and adjuvant treatment. The association with risk of recurrent disease was analyzed using logistic regression adjusted for age, stage, and grade. Morbidity data were analyzed using χ2 tests.ResultsMedian follow-up was 45.8 months. Overall survival at 3 years was 93%. Lymphadenectomy was performed in 217 women (66%), 16% of this group having positive nodes. Median node count was 12. There were no significant differences in OS between LND and no LND groups, or by number of nodes removed. After excluding stage IB grade 1/2 tumors, there was no association between LND and OS among a “high-risk” group of 190 women with a positive node rate of 24%. However, a similar cohort (n = 71) of serous EC in the Australian National Endometrial Cancer Study had improved survival after LND. Women who underwent LND had significantly higher rates of critical events (5% vs 0%, P = 0.02) and lymphoedema (23% vs 4%, P < 0.0001).ConclusionsIn this cohort with early-stage intermediate-/high-risk endometrioid EC, LND did not improve survival but was associated with significantly increased morbidity.

Outcome of High-Risk Stage IC, Grade 3, Compared With Stage I Endometrial Carcinoma Patients: The Postoperative Radiation Therapy in Endometrial Carcinoma Trial

2004 ◽  
Vol 22 (7) ◽  
pp. 1234-1241 ◽  
Author(s):  
Carien L. Creutzberg ◽  
Wim L.J. van Putten ◽  
Carla C. Wárlám-Rodenhuis ◽  
Alfons C.M. van den Bergh ◽  
Karin A.J. De Winter ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
High Risk ◽  
Endometrial Carcinoma ◽  
Postoperative Radiotherapy ◽  
Risk Category ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Stage Ib ◽  
Grade 3

Purpose Stage IC, grade 3 endometrial cancer is regarded as a high-risk category. Stage IC, grade 3 patients were not eligible for the randomized Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial, but were registered and received postoperative radiotherapy. Patients and Methods The PORTEC trial included 715 patients with stage IC, grade 1 or 2, and stage IB, grade 2 or 3 endometrial cancer. Patients were randomly assigned after surgery to receive pelvic radiotherapy (RT) or no further treatment. A total of 104 patients with stage IC, grade 3 endometrial cancer were registered, of whom 99 could be evaluated. Patterns of relapse and survival were compared with PORTEC patients receiving RT. Median follow-up was 83 months. Results The actuarial 5-year rates of locoregional relapse were 1% to 3% for PORTEC patients who received RT, compared with 14% for stage IC, grade 3 patients. Five-year distant metastases rates were 3% to 8% for grade 1 and 2 tumors; 20% for stage IB, grade 3 tumors; and 31% for stage IC, grade 3 tumors. Overall survival rates were 83% to 85% for grades 1 and 2; 74% for stage IB, grade 3; and 58% for stage IC, grade 3 patients (P < .001). In multivariate analysis grade 3 was the most important adverse prognostic factor for relapse and death as a result of endometrial cancer (hazard ratios, 5.4 and 5.5; P < .0001). Conclusion Patients with stage IC, grade 3 endometrial carcinoma are at high risk of early distant spread and endometrial carcinoma-related death. Novel strategies for adjuvant therapy should be explored to improve survival for this patient group.

scholarly journals CTNNB1 (beta-catenin) mutation in grade 1-2 endometrioid endometrial cancer identifies a high-risk subgroup

2016 ◽  
Vol 141 ◽  
pp. 17-18 ◽  
Author(s):  
K.C. Kurnit ◽  
B. Fellman ◽  
D. Urbauer ◽  
G.B. Mills ◽  
R. Broaddus
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Beta Catenin ◽  
Endometrioid Endometrial Cancer

scholarly journals Is Tumor-Free Distance an Independent Prognostic Factor for Early-Stage Endometrioid Endometrial Cancer?

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tufan Oge ◽  
Duygu Kavak Comert ◽  
Yusuf Cakmak ◽  
Deniz Arık
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Myometrial Invasion ◽  
Independent Prognostic Factor ◽  
Depth Of Invasion ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Free Distance ◽  
Stage Ib ◽  
Endometrioid Endometrial Cancer

There are many studies assessing the importance of myometrial invasion using a cut-off limit as 50% of myometrial invasion for endometrial cancer, and there are a limited number of studies evaluating tumor-free distance to the serosa. To evaluate the prognostic performance of tumor-free distance and percentage of myometrial invasion in patients with stage IB endometrioid endometrial cancer, we retrospectively evaluated 133 patients diagnosed and treated as stage IB endometrioid endometrial cancer. Tumor-free distance was assessed, and recurrence and recurrence-free survival were analyzed. Nine patients had recurrent disease (6.8%). Recurrence-free survival was 200 months. Two patients died because of malignancy. In the Cox regression model according to tumor-free distance, depth of invasion, and percentage of myometrial invasion, it was seen that none of these parameters were significant to predict the recurrence (p>0.05). In conclusion, tumor-free distance is not an independent prognostic factor for patients with stage IB endometrioid endometrial cancer.

Adjuvant chemotherapy in early-stage endometrioid endometrial cancer with >50% myometrial invasion and negative lymph nodes

2021 ◽  
Vol 31 (4) ◽  
pp. 537-544
Author(s):  
Francesco Multinu ◽  
Simone Garzon ◽  
Amy L Weaver ◽  
Michaela E. McGree ◽  
Enrico Sartori ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Endometrioid Endometrial Cancer ◽  
Negative Lymph Nodes

ObjectiveThe role of adjuvant chemotherapy as an addition or alternative to radiotherapy for early-stage high-risk endometrioid endometrial cancer is controversial. This study aimed to investigate the role of adjuvant chemotherapy in early-stage high-risk endometrioid endometrial cancer.MethodsWe identified patients with stage I or II endometrioid grade 2 or 3 endometrial cancer with myometrial invasion >50% and negative lymph nodes after pelvic with or without para-aortic lymphadenectomy at four institutions (USA and Italy). Associations between chemotherapy and cause-specific and recurrence-free survival were assessed with Cox proportional hazards models. Hematogenous, peritoneal, and lymphatic recurrences were defined as 'non-vaginal'.ResultsWe identified 329 patients of mean (SD) age 66.4 (9.8) years. The median follow-up among those alive was 84 (IQR 44–133) months. The 5-year cause-specific survival was 86.1% (95% CI 82.0% to 90.4%) and the 5-year recurrence-free survival was 82.2% (95% CI 77.9% to 86.8%). Stage II (vs stage IB) was associated with poorer cause-specific and recurrence-free survival. A total of 58 (90.6%) of 64 patients who had chemotherapy had 4–6 cycles of platinum-based regimen. In adjusted analysis, we did not observe a statistically significant improvement in cause-specific survival (HR 0.34; 95% CI 0.11 to 1.03; p=0.06) or non-vaginal recurrence-free survival (HR 0.36; 95% CI 0.12 to 1.08; p=0.07) with adjuvant chemotherapy. Sixteen of 18 lymphatic recurrences (88.9%; 3/5 pelvic, all 13 para-aortic) were observed in the 265 patients who did not receive adjuvant chemotherapy. Among stage II patients, no deaths (100% 5-year recurrence-free survival) were observed in the eight patients who received adjuvant chemotherapy compared with 66% 5-year recurrence-free survival in the 34 patients who did not.ConclusionAlthough we observed that adjuvant chemotherapy was associated with improved oncologic outcomes in early-stage high-risk endometrioid endometrial cancer, the associations did not meet conventional levels of statistical significance. Further research is warranted in this relatively uncommon subgroup of patients.

Sign in / Sign up

Export Citation Format

Share Document