EP583 Surgical management of the endometrial cancer and analysis of the surgical prognostic factors for disease recurrence and overall survival

2019 ◽  
Author(s):  
J Molero Vílchez ◽  
E Martínez Lamela ◽  
S Sancho García ◽  
E Bancarali Rojnica
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Surgical Management ◽  
Disease Recurrence

Treatment outcomes of endometrial cancer patients with paraaortic lymph node metastasis: a multi-institutional analysis

2019 ◽  
Vol 29 (1) ◽  
pp. 94-101 ◽  
Author(s):  
Cem Onal ◽  
Berna Akkus Yildirim ◽  
Sezin Yuce Sari ◽  
Guler Yavas ◽  
Melis Gultekin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Adjuvant Radiotherapy ◽  
Survival Rates ◽  
Myometrial Invasion ◽  
Progression Free Survival ◽  
Free Survival ◽  
Radiotherapy Alone ◽  
Paraaortic Lymph Node Metastasis

ObjectiveTo analyze the prognostic factors and treatment outcomes in endometrial cancer patients with paraaortic lymph node metastasis.MethodsData from four centers were collected retrospectively for 92 patients with endometrial cancer treated with combined radiotherapy and chemotherapy or adjuvant radiotherapy alone postoperatively, delivered by either the sandwich or sequential method. Prognostic factors affecting overall survival and progression-free survival were analyzed.ResultsThe 5-year overall survival and progression-free survival rates were 35 % and 33 %, respectively, after a median follow-up time of 33 months. The 5-year overall survival and progression-free survival rates were significantly higher in patients receiving radiotherapy and chemotherapy postoperatively compared with patients treated with adjuvant radiotherapy alone (P < 0.001 and P < 0.001, respectively). In a subgroup analysis of patients treated with adjuvant combined chemotherapy and radiotherapy, the 5-year overall survival and progression-free survival rates were significantly higher in patients receiving chemotherapy and radiotherapy via the sandwich method compared with patients treated with sequential chemotherapy and radiotherapy (P = 0.02 and P = 0.03, respectively). In the univariate analysis, in addition to treatment strategy, pathology, depth of myometrial invasion, and tumor grade were significant prognostic factors for both overall survival and progression-free survival. In the multivariate analysis, grade III disease, myometrial invasion greater than or equal to 50%, and adjuvant radiotherapy alone were negative predictors for both overall survival and progression-free survival.ConclusionWe demonstrated that adjuvant combined treatment including radiotherapyand chemotherapy significantly increases overall survival and progression-free survival rates compared with postoperative pelvic and paraaortic radiotherapy.

scholarly journals The effect of myometrial invasion on prognostic factors and survival analysis in endometrial carcinoma

1970 ◽  
Vol 19 (4) ◽  
pp. 3235-3241
Author(s):  
Cem Dane ◽  
Sait Bakir
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Free Survival ◽  
The Relationship

Background: We investigated the relationship between myometrial invasion and the prognostic factors on overall and progression free survival in endometrial carcinoma.Methods: 122 cases operated with endometrial cancer were included into the study. Progression-free survival and overall survival were evaluated according to degree of myometrial invasion. We also investigated the relationship between myometrial invasion and prognostic factors. Results: The 5- year progression-free survival rate was 90 % in stage I, 66 % in stage II, 32 % in stage III and 60 % in stage IV. The 5- year overall survival rate was 95 % in stage I, 89 % in stage II, 49 % in stage III and 30 % in stage IV. The progression free survival and overall survival for patients with more than 50 % myometrial invasion were detected 67 % at 58 months and 66 % at 60 months, respectively. The clinicopathological variables that significantly correlated with myometrial invasion of more than 50 % were as follows: pelvic lymph node metastasis (p: 0,00029-OR: 11.2), cervical stromal invasion (p: 0008-OR:7.9), LVSI (p< 0.0001-OR: 16.5).Conclusion: The depth of myometrial invasion is one of the most important prognostic indicators and determinants of therapy in endometrial cancer. Keywords: Endometrial carcinoma; Progression free survival; Overall survival; Prognostic factors.

scholarly journals Survival and prognostic factors of lymphadenectomy in endometrial cancer: a Tunisian single center experience

2018 ◽  
Vol 5 (11) ◽  
pp. 3658
Author(s):  
Ines Ben Safta ◽  
Olfa Jaidane ◽  
Houyem Mansouri ◽  
Raoudha Doghri ◽  
Selma Gadria ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Node Ratio ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Node Ratio ◽  
The Impact

Background: Endometrial cancer (EC) is the most common pelvic gynecological cancer. The purpose of the present study is to identify histoprognostic risk factors for lymph node involvement, evaluate the impact of lymphadenectomy on relapse and overall survival and assess prognostic factors influencing the survival rates in endometrial cancer.Methods: This was a retrospective study of 249 cases of endometrial cancer, over a period of 16 years (2000-2015). We analyzed the clinical, pathological features and outcome of our patients. Curves of overall and recurrence-free survival were performed.Results: In our cohort, stage IA was found in 46.6% of cases, stage IB in 14.5%, stage II in 13.7%, stage IIIA in 3.6%, stage IIIB in 2%, stage IIIC1 in 8.8%, stage IIIC2 in 4.4% and stage IV in 6.4%. The histologic type (p=0.02, OR=2.702, CI [1.169; 6.25]), myometrial invasion (p<0.001, OR=4.524, CI [1.960; 10.416]), lymphovascular space invasion (p=0.047, OR=2.267; CI [1.013; 5.076]) were the only independent factors of lymph node invasion in multivariate analysis. 5-years overall and recurrence free survival was 76.3% and 81.5%, respectively. Overall survival at 5 years was 64.6% with a lymph node ratio of less than 10%, 22.2% with a lymph node ratio between 10 and 50%, and zero with a lymph node ration greater than 50% (p=0.016). By studying the number of lymph nodes removed during lymphadenectomy, survival trend to be improved when the lymph node count increased.Conclusions: The lymphadenectomy has an incontestable diagnostic and prognostic value. Present retrospective study showed the therapeutic interest of lymph node dissection in endometrial cancers.

scholarly journals Outcomes and Prognostic Factors in Patients with Malignant Peripheral Nerve Sheath Tumor

2021 ◽  
Vol 73 (11) ◽  
pp. 763-771
Author(s):  
Chindanai Hongsaprabhas ◽  
Sorranart Muangsomboon ◽  
Chandhanarat Chandhanayingyong ◽  
Rapin Phimolsarnti ◽  
Saranatra Waikakul ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Oncologic Outcomes ◽  
Nerve Sheath Tumor ◽  
Chemotherapy Treatment ◽  
Tumor Margin ◽  
Disease Free

Objective: To investigate and report the clinical profiles, treatment patterns, and oncologic outcomes in MPNST patients, and to identify the prognostic factors that significantly affect survival.Materials and Methods: Patients diagnosed with and treated for histologically confirmed MPNST at our institute during the January 1997 to June 2018 study period were included. Patient medical records and surgical specimens were reviewed, and study-related data was extracted and analyzed.Results: There were 27 males and 32 females with a mean age of 44 years. Most patients presented with mass and most patients were AJCC stage III. Twenty-nine percent of patients had MPNST that was associated with NF-1. At a median follow-up time, 18 patients (30.51%) suffered from local disease recurrence. Two-year and 5-year overall survival was 72% and 46%, respectively. In univariate analysis, chemotherapy treatment and positive tumor margin were adverse prognostic factors for disease-free survival. In multivariate analysis, chemotherapy treatment (hazard ratio (HR): 3.415, 95% CI: 1.367-16.021; p=0.013) and positive tumor margin (HR: 4.680, 95% CI 1.828-10.314; p=0.014) were found to be independent prognostic factors for disease-free.Conclusion: Chemotherapy treatment and positive tumor margin were identified as independent adverse prognostic factors for disease-free and overall survival, respectively. Accordingly, early detection and appropriate treatment are essential for improved patient outcome.

scholarly journals Overall survival and disease-free survival in endometrial cancer: prognostic factors in 276 patients

2013 ◽  
pp. 1305 ◽  
Author(s):  
Jesus S Jimenez ◽  
Alvaro Tejerizo-Garcia ◽  
Jose L. Munoz-Gonzalez ◽  
Sara Bartolomé-Sotillos ◽  
Laura Marqueta-Marqués ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Endometrial cancer in young women: prognostic factors and treatment outcomes in women aged ≤40 years

2020 ◽  
Vol 30 (5) ◽  
pp. 631-639 ◽  
Author(s):  
Ji Son ◽  
Caitlin Carr ◽  
Meng Yao ◽  
Milena Radeva ◽  
Anju Priyadarshini ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Myometrial Invasion ◽  
Progression Free Survival ◽  
Lymph Node Status ◽  
Free Survival ◽  
Fertility Sparing ◽  
Mlh1 Methylation ◽  
Lymphovascular Space Invasion

ObjectiveEndometrial cancer in pre-menopausal patients aged ≤40 years is rare and poses both diagnostic and management challenges. The goal of this study was to investigate the clinical and pathologic factors associated with endometrial cancer in this group and their impact on survival.MethodsPatients with endometrial cancer treated between January 2004 and August 2016 were retrospectively reviewed. Patients who underwent either primary surgical treatment or fertility-sparing therapy were included. Exclusion criteria were age >60 years and patients who received neoadjuvant chemotherapy or primary radiation. Age at diagnosis was used to classify patients into two groups: ≤40 and 41–60 years. Clinical and pathologic variables were compared between the groups. Progression-free survival and overall survival were estimated using Cox proportional hazards.ResultsA total of 551 patients were evaluated, of which 103 (18.7%) patients were ≤40 years and 448 (81.3%) were 41–60 years. Age ≤40 years was associated with higher body mass index (38.8 vs 35.8 kg/m2, p=0.008), non-invasive cancers (54.2% vs 32.6%, p<0.001), lower uterine segment involvement (27.2% vs 22.5%, p<0.001), and less lymphovascular space invasion (16.8% vs 29.1%, p=0.015). The rate of synchronous ovarian cancer was 9.2% vs 0.7% in age 41–60 years (p<0.001), and 19% of women with endometrial cancer aged ≤40 years underwent fertility-sparing therapy. Grade, stage, myometrial invasion, lymphovascular space invasion, and lymph node status were associated with survival, and fertility-sparing therapy adversely affected the recurrence rate of the age ≤40 years cohort. Among all patients aged ≤60 years, mismatch repair deficiency due to MLH1 methylation was associated with worse progression-free survival, 48.6% vs 83.3% (HR 1.98, 95% CI 1.06 to 3.17, p=0.032), and overall survival, 56.5% vs 90.0% (HR 2.58, 95% CI 1.13 to 5.90, p=0.025).ConclusionsPatients aged ≤40 years with endometrial cancer have more favorable prognostic factors and higher rates of synchronous tumors. Fertility-sparing therapy was associated with higher recurrence rates. The prognostic value of MLH1 methylation in this population warrants further investigation.

Natural history and surgical management of incidentally discovered low-grade gliomas

2012 ◽  
Vol 116 (2) ◽  
pp. 365-372 ◽  
Author(s):  
Matthew B. Potts ◽  
Justin S. Smith ◽  
Annette M. Molinaro ◽  
Mitchel S. Berger
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Surgical Management ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Lead Author ◽  
Low Grade ◽  
Language Mapping ◽  
Low Grade Gliomas ◽  
Incidental Lesions

Object Low-grade gliomas (LGGs) are rarely diagnosed as an incidental, asymptomatic finding, and it is not known how the early surgical management of these tumors might affect outcome. The purpose of this study was to compare the outcomes of patients with incidental and symptomatic LGGs and determine any prognostic factors associated with those outcomes. Methods All patients treated by the lead author for an LGG incidentally discovered between 1999 and 2010 were retrospectively reviewed. “Incidental” was defined as a finding on imaging that was obtained for a reason not attributable to the glioma, such as trauma or headache. Primary outcomes included overall survival, progression-free survival (PFS), and malignant PFS. Patients with incidental LGGs were compared with a previously reported cohort of patients with symptomatic gliomas. Results Thirty-five patients with incidental LGGs were identified. The most common reasons for head imaging were headache not associated with mass effect (31.4%) and trauma (20%). Patients with incidental lesions had significantly lower preoperative tumor volumes than those with symptomatic lesions (20.2 vs 53.9 cm3, p < 0.001), were less likely to have tumors in eloquent locations (14.3% vs 61.9%, p < 0.001), and had a higher prevalence of females (57.1% vs 36%, p = 0.02). In addition, patients with incidental lesions were also more likely to undergo gross-total resection (60% vs 31.5%, p = 0.001) and had improved overall survival on Kaplan-Meier analysis (p = 0.039, Mantel-Cox test). Progression and malignant progression rates did not differ between the 2 groups. Univariate analysis identified pre- and postoperative volumes as well as the use of motor or language mapping as significant prognostic factors for PFS. Conclusions In this retrospective cohort of surgically managed LGGs, incidentally discovered lesions were associated with improved patient survival as compared with symptomatic LGGs, with acceptable surgical risks.

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