Pilot Study with Adjuvant Hormone Therapy in Figo Stage I Endometrial Carcinoma with Myometrial Invasion

1983 ◽  
Vol 69 (1) ◽  
pp. 65-67 ◽  
Author(s):  
Giuseppe De Palo ◽  
Giovanni Battista Spatti ◽  
Gaetano Bandieramonte ◽  
Luciano Luciani
Keyword(s):  
Pilot Study ◽  
Hormone Therapy ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Stage I ◽  
Control Group ◽  
Relapse Free Survival ◽  
Adjuvant Hormone Therapy ◽  
Free Survival

A pilot study with adjuvant hormone therapy in FIGO stage I endometrial carcinoma with myometrial invasion was carried out. All patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy plus complementary radium therapy on the vaginal stump. After the conventional treatment, patients were randomly allocated to adjuvant hormone therapy or no further treatment. Hormone therapy consisted of gestonorone caproate (17α-hydroxy-19-norpregn-4-en 3,20 dione caproate) administered i.m. at the dose of 200 mg/week for 1 year. Of the 62 patients who entered the study, 51 were considered evaluable (24 with adjuvant hormone therapy and 27 with no further treatment). Five patients had a relapse: four of these were in the group with no further treatment. Actuarial relapse-free survival analysis at 5 years was 95.7% in the group of adjuvant-treated patients and 82.8% in the control group. Although there is no statistical significance, adjuvant therapy appears to result in an increase in relapse-free survival in the group of patients with deep myometrial invasion and undifferentiated carcinoma. Further studies are necessary to assess the effectiveness of hormone adjuvant treatment in FIGO stage I endometrial carcinoma with myometrial invasion.

scholarly journals Prognostic parameters in FIGO stage I endometrial carcinoma of endometrioid type

2006 ◽  
Vol 63 (12) ◽  
pp. 1006-1010 ◽  
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.

Nodal immune reactivity in FIGO Stage I endometrial carcinoma: relationship with myometrial invasion

1995 ◽  
Vol 74 (9) ◽  
pp. 723-728 ◽  
Author(s):  
Giuseppe Gioele Garzetti ◽  
Andrea Ciavattini ◽  
Gaia Goteri ◽  
Carlo Romanini
Keyword(s):  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Stage I ◽  
Immune Reactivity

scholarly journals Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linqi Zhang ◽  
Xi Long ◽  
Mayidili Nijiati ◽  
Tianhui Zhang ◽  
Mengsi Li ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Figo Stage ◽  
Stage I ◽  
Histological Subtype ◽  
Cutoff Value ◽  
Poorly Differentiated ◽  
Tumor Stiffness

Abstract Background Preoperative evaluation of aggressiveness, including tumor histological subtype, grade of differentiation, Federation International of Gynecology and Obstetrics (FIGO) stage, and depth of myometrial invasion, is significant for treatment planning and prognosis in endometrial carcinoma (EC). The purpose of this study was to evaluate whether three-dimensional (3D) magnetic resonance elastography (MRE) can help predict the aggressiveness of EC. Methods From August 2015 to January 2019, 82 consecutive patients with suspected uterine tumors underwent pelvic MRI and MRE scans, and 15 patients with confirmed EC after surgical resection were enrolled. According to pathological results (tumor grade, histological subtype, FIGO stage, and myometrial invasiveness), the patients were divided into two subgroups. The independent-samples t-test or Mann-Whitney U test was used to compare the stiffness between different groups. The diagnostic performance was determined with receiver operating characteristic (ROC) curve analysis. Results The stiffness of EC with ≥ 50 % (n = 6) myometrial invasion was significantly higher than that with < 50 % (n = 9) myometrial invasion (3.68 ± 0.59 kPa vs. 2.61 ± 0.72 kPa, p = 0.009). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 77.8 % specificity for differentiating ≥ 50 % myometrial invasion from < 50 % myometrial invasion of EC. The stiffness of poorly differentiated EC (n = 8) was significantly higher than that of well/moderately differentiated EC (n = 7) (3.47 ± 0.64 kPa vs. 2.55 ± 0.82 kPa, p = 0.028). Using a stiffness of 3.04 kPa as a cutoff value resulted in 75 % sensitivity and 71.4 % specificity for differentiating poorly differentiated from well/moderately differentiated EC. The stiffness of FIGO stage II/III EC was significantly higher than that of FIGO stage I EC (3.69 ± 0.65 kPa vs. 2.72 ± 0.76 kPa, p = 0.030). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 70 % specificity for differentiating FIGO stage I EC from FIGO stage II/III EC. The tumor stiffness value in type II (n = 3) EC was higher than that in type I (n = 12) EC (3.67 ± 0.59 kPa vs. 2.88 ± 0.85 kPa), but the difference was not significant (p = 0.136). Conclusions Tumor stiffness measured by 3D MRE may be potentially useful for predicting tumor grade, FIGO stage and myometrial invasion of EC and can aid in the preoperative risk stratification of EC.

Intraoperative frozen section examination of myometrial invasion depth in patients with endometrial carcinoma

1994 ◽  
Vol 4 (5) ◽  
pp. 352-355 ◽  
Author(s):  
J. Atad ◽  
Y. Ben-David ◽  
M. Hallak ◽  
O. Klein ◽  
H. Abramovici ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Frozen Section ◽  
Myometrial Invasion ◽  
Accurate Method ◽  
Figo Stage ◽  
Stage I ◽  
Frozen Sections ◽  
Invasion Depth ◽  
Surgical Specimen ◽  
Deep Myometrial Invasion

The objective of this study was to evaluate the accuracy of frozen sections (FS) as a method for estimation of the depth of myometrial invasion in patients with stage I endometrial carcinoma. During a 3-year period (1989–1992), 46 consecutive patients with FIGO stage I endometrial carcinoma were included in this study. The depth of myometrial invasion was estimated by FS examination performed during surgery. The final histologic findings of the surgical specimen were compared to the FS evaluation. The results of this study demonstrate that deep or superficial myometrial invasions were correctly diagnosed by FS in 42 out of 46 cases (91.3%). Three cases (6.6%) with deep myometrial invasion were falsely diagnosed as superficially invasive. One case with superficial invasion (2.1%) was falsely diagnosed as deeply invasive. In conclusion, intraoperative FS examination of depth of myometrial invasion by endometrial carcinoma is a simple and accurate method, providing a good correlation with the final histologic report of the surgical specimen.

A Retrospective Analysis of 53 Patients with Pathologic Stage II and III Endometrial Carcinoma

1982 ◽  
Vol 68 (4) ◽  
pp. 341-347 ◽  
Author(s):  
Giuseppe De Palo ◽  
Rado Kenda ◽  
Salvatore Andreola ◽  
Gaetano Bandieramonte ◽  
Luciano Luciani ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Retrospective Analysis ◽  
Myometrial Invasion ◽  
Stage Ii ◽  
Stage Iii ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Pathologic Stage ◽  
Factors Influencing ◽  
Degree Of Differentiation

From 1969 to 1977, 53 patients with surgical-pathologic stages II and III endometrial carcinoma were seen at the Istituto Nazionale Tumori of Milan. The treatment was individualized. The 5-year survival was 68.8% in stage II and 75.3% in stage III. The relapse-free survival was 68.9% and 69.4%, respectively. Adjuvant type of radiotherapy, degree of differentiation, depth of myometrial invasion, and especially sites of disease were the factors influencing survival.

scholarly journals Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I–II nasopharyngeal carcinoma: a nest case-control study

2021 ◽  
Author(s):  
Bei-Bei Xiao ◽  
Qiu-Yan Chen ◽  
Xue-Song Sun ◽  
Ji-Bin Li ◽  
Dong-hua Luo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Stage I ◽  
Relapse Free Survival ◽  
Retropharyngeal Lymph Node ◽  
Free Survival ◽  
Pet Ct ◽  
Pre Treatment

Abstract Objectives The value of using PET/CT for staging of stage I–II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. Methods A total of 1003 patients with pathologically confirmed NPC of stages I–II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. Results Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3–82.1] vs. 91.1% [84.8–97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8–100.0] vs. 76.4% [67.6–85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. Conclusions This study showed PET/CT is of little value for staging of stage I–II NPC patients at initial imaging. Key Points • PET/CT was more sensitive than MRI in detecting neck lymph node lesions whereas it was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions. • No association existed between pre-treatment PET/CT use and improved survival in stage I–II NPC patients.

The Importance of Lymphovascular Invasion in Uterine Adenosarcomas: Analysis of Clinical, Prognostic, and Treatment Outcomes

2018 ◽  
Vol 28 (7) ◽  
pp. 1297-1310 ◽  
Author(s):  
Michael J. Nathenson ◽  
Anthony P. Conley ◽  
Heather Lin ◽  
Nicole Fleming ◽  
Alexander Lazar ◽  
...  
Keyword(s):  
Survival Data ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Gynecology And Obstetrics ◽  
Resection Status

ObjectiveThis retrospective study examined the clinicopathologic features of adenosarcoma patients to determine potential prognostic factors and retrospectively evaluated overall survival (OS), disease-free survival (DFS), and local recurrence-free survival (LRFS) after primary treatment of adenosarcoma including surgery, radiation, and chemotherapy.MethodsOne hundred sixty-five patients with adenosarcoma were identified from the MD Anderson Cancer Center tumor registry between 1982 and 2014. Clinical data were collected retrospectively. Pathologic characteristics were examined by sarcoma pathologists. We used the Kaplan-Meier method to estimate OS, DFS, and LRFS. The log-rank test was performed to test the difference in survival between groups. Multivariate regression analyses of survival data were conducted using the Cox proportional hazards model.ResultsMedian OS and DFS for all patients were 8.5 and 4.7 years, respectively. Pathologic characteristics that influence OS and DFS were sarcomatous overgrowth (SO), myometrial invasion (MI), lymphovascular invasion (LVI), tumor size, number of mitosis, estrogen receptor, progesterone receptor, International Federation of Gynecology and Obstetrics (FIGO) stage, age, and resection status. Median OS for adenosarcoma patients with SO was 5.2 versus 14.5 years for patients without SO (P < 0.0001). Median OS for adenosarcoma patients with MI was 5.8 years versus not reached for patients without MI (P = 0.0005). Median OS for adenosarcoma patients with LVI was 1.0 versus 8.9 years for patients without LVI (P = 0.0021). On Cox analysis for OS and DFS and LRFS, only SO, MI, LVI, age, resection status, and FIGO stage remained significant. There was no difference in OS or LRFS for adjuvant radiation versus no adjuvant radiation (P = 0.17, P = 0.076).ConclusionsThis study highlights the importance of LVI as a prognostic factor and confirms the prognostic significance of SO, MI, age, resection status, and FIGO stage for adenosarcoma. Furthermore, this study suggests that there is no additional benefit to adjuvant radiation. The standard-of-care treatment for adenosarcoma should remain total abdominal hysterectomy bilateral salpingo-oophorectomy +/− lymphadenectomy and no adjuvant radiation.

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

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.

scholarly journals MRI-based radiomics and ADC values are related to recurrence of endometrial carcinoma: a preliminary analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaiyue Zhang ◽  
Yu Zhang ◽  
Xin Fang ◽  
Jiangning Dong ◽  
Liting Qian
Keyword(s):  
Endometrial Carcinoma ◽  
Cox Regression ◽  
Myometrial Invasion ◽  
Test Group ◽  
Inverse Correlation ◽  
Training Group ◽  
Figo Stage ◽  
Clinicopathological Features ◽  
Prognostic Information ◽  
Adc Values

Abstract Background To identify predictive value of apparent diffusion coefficient (ADC) values and magnetic resonance imaging (MRI)-based radiomics for all recurrences in patients with endometrial carcinoma (EC). Methods One hundred and seventy-four EC patients who were treated with operation and followed up in our institution were retrospectively reviewed, and the patients were divided into training and test group. Baseline clinicopathological features and mean ADC (ADCmean), minimum ADC (ADCmin), and maximum ADC (ADCmax) were analyzed. Radiomic parameters were extracted on T2 weighted images and screened by logistic regression, and then a radiomics signature was developed to calculate the radiomic score (radscore). In training group, Kaplan–Meier analysis was performed and a Cox regression model was used to evaluate the correlation between clinicopathological features, ADC values and radscore with recurrence, and verified in the test group. Results ADCmean showed inverse correlation with recurrence, while radscore was positively associated with recurrence. In univariate analyses, FIGO stage, pathological types, myometrial invasion, ADCmean, ADCmin and radscore were associated with recurrence. In the training group, multivariate Cox analysis showed that pathological types, ADCmean and radscore were independent risk factors for recurrence, which were verified in the test group. Conclusions ADCmean value and radscore were independent predictors of recurrence of EC, which can supplement prognostic information in addition to clinicopathological information and provide basis for individualized treatment and follow-up plan.

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