scholarly journals Prospective Cohort Study of Pre- and Postdiagnosis Physical Activity and Endometrial Cancer Survival

2020 ◽  
Vol 38 (34) ◽  
pp. 4107-4117
Author(s):  
Christine M. Friedenreich ◽  
Linda S. Cook ◽  
Qinggang Wang ◽  
Renée L. Kokts-Porietis ◽  
Jessica McNeil ◽  
...  
Keyword(s):  
Physical Activity ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Cohort Study ◽  
Disease Free Survival ◽  
Activity Levels ◽  
Recreational Physical Activity ◽  
Free Survival ◽  
Physical Activity Levels ◽  
Disease Free

PURPOSE The aim of this study was to evaluate associations between pre- and postdiagnosis physical activity and survival in survivors of endometrial cancer by physical activity domain, intensity, dose (metabolic-equivalent task [MET]-hours/week/year), and change from pre- to postdiagnosis. METHODS We conducted a prospective cohort study in Alberta, Canada, of 425 women who were diagnosed with histologically confirmed invasive endometrial cancer between 2002 and 2006 and observed to 2019. The interviewer-administered Lifetime Total Physical Activity Questionnaire recorded prediagnosis (assessed at a median of 4.4 months after diagnosis) and postdiagnosis physical activity (assessed at a median of 3.4 years after diagnosis). Associations between physical activity and overall and disease-free survival were assessed using Cox proportional hazards models adjusted for age, stage, grade, treatments, body mass index, menopausal status, hormone therapy use, family history of cancer, and comorbidities. RESULTS After a median follow-up of 14.5 years, there were 60 deaths, including 18 endometrial cancer deaths, and 80 disease-free survival events. Higher prediagnosis recreational physical activity was statistically significantly associated with improved disease-free survival (> 14 v ≤ 8 MET-hours/week/year; hazard ratio [HR], 0.54; 95% CI, 0.30 to 0.96; Ptrend = .04), but not overall survival (HR, 0.56; 95% CI, 0.29 to 1.07; Ptrend = .06). Higher postdiagnosis recreational physical activity (> 13 v ≤ 5 MET-hours/week/year) was strongly associated with both improved disease-free survival (HR, 0.33; 95% CI, 0.17 to 0.64; Ptrend = .001) and overall survival (HR, 0.33; 95% CI, 0.15 to 0.75; Ptrend = .007). Participants who maintained high recreational physical activity levels from pre- to postdiagnosis also had improved disease-free survival (HR, 0.35; 95% CI, 0.18 to 0.69) and overall survival (HR, 0.43; 95% CI, 0.20 to 0.94) compared with those who maintained low physical activity levels. CONCLUSION Recreational physical activity, especially postdiagnosis, is associated with improved survival in survivors of endometrial cancer.

A Prospective Cohort Study Of Physical Activity In Relation To Disease-free Survival Of Breast Cancer In Women Diagnosed With Breast Cancer

2005 ◽  
Vol 37 (Supplement) ◽  
pp. S358
Author(s):  
Melinda Irwin ◽  
Anne McTiernan ◽  
Rick Baumgartner ◽  
Kathy Baumgartner ◽  
Leslie Bernstein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Role of adjuvant therapy in stage IIIC2 endometrial cancer

2020 ◽  
Vol 30 (8) ◽  
pp. 1169-1176
Author(s):  
Giorgio Bogani ◽  
Serena Cappuccio ◽  
Jvan Casarin ◽  
Deepa Maheswari M Narasimhulu ◽  
William A Cilby ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Adjuvant Therapy ◽  
External Beam Radiotherapy ◽  
Disease Free Survival ◽  
External Beam ◽  
Free Survival ◽  
Radiotherapy Alone ◽  
Node Metastases ◽  
Disease Free

ObjectiveThe role of the different types of adjuvant treatments in endometrial cancer with para-aortic node metastases is unclear. The aim of this study was to report oncologic outcomes after adjuvant therapy in patients with stage IIIC2 endometrial cancer.MethodsThis retrospective single-institution study assessed patients with stage IIIC2 endometrial cancer who underwent primary surgery from January 1984 to December 2014. All patients had hysterectomy (±salpingo-oophorectomy) plus lymphadenectomy (para-aortic nodes, ±pelvic nodes). We included all patients with stage III endometrial cancer and documented para-aortic lymph node metastases (International Federation of Obstetrics and Gynecologists stage IIIC2). We excluded patients who did not provide consent, who had synchronous cancer, or who underwent neoadjuvant chemotherapy. Follow-up was restricted to the first 5 years post-operatively. Cox proportional hazards models, with age as the time scale, was used to evaluate associations of risk factors with disease-free survival and overall survival.ResultsAmong 105 patients with documented adjuvant therapy, external beam radiotherapy was administered to 25 patients (24%), chemotherapy to 24 (23%), and a combination (chemotherapy and external beam radiotherapy) to 56 (53%) patients. Most patients receiving chemotherapy and external beam radiotherapy (80%) had chemotherapy first. The majority of relapses had a distant component (31/46, 67%) and only one patient had an isolated para-aortic recurrence. Non-endometrioid subtypes had poorer disease-free survival (HR 2.57; 95% CI 1.38 to 4.78) and poorer overall survival (HR 2.00; 95% CI 1.09 to 3.65) compared with endometrioid. Among patients with endometrioid histology (n=60), chemotherapy and external beam radiotherapy improved disease-free survival (HR 0.22; 95% CI 0.07 to 0.71) and overall survival (HR 0.28; 95% CI 0.09 to 0.89) compared with chemotherapy or external beam radiotherapy alone. Combination therapy did not improve prognosis for patients with non-endometrioid histology (n=45).ConclusionsIn our cohort of patients with stage IIIC2 endometrioid endometrial cancer, those receiving chemotherapy and external beam radiotherapy had improved survival compared with patients receiving chemotherapy or external beam radiotherapy alone. However, the prognosis of patients with non-endometrioid endometrial cancer remained poor, regardless of the adjuvant therapy administered. Distant recurrences were the most common sites of failure.

scholarly journals Stage IB Endometrioid Type Endometrial Cancer: The Role of Lymphadenectomy and Adjuvant Radiation Therapy

2018 ◽  
Vol 24 (3) ◽  
pp. 156
Author(s):  
Osman Turkmen ◽  
Tolga Tasci ◽  
Derman Basaran ◽  
Gunsu Comert Kimyon ◽  
Alper Karalök ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Stage Ib ◽  
Gynecology And Obstetrics ◽  
Disease Free

<p><strong>Objective:</strong> Both performances of lymphadenectomy and benefit of adding adjuvant radiotherapy are controversial for patients with International Federation of Gynecology and Obstetrics stage IB endometrioid type endometrial cancer. We aimed to identify the role of lymphadenectomy and adjuvant radiation therapy as well as clinicopathological prognostic factors for this group of patients.<br /><strong></strong></p><p><strong>Study Design:</strong> Records of all patients (n=132) with stage IB endometrioid endometrial cancer who were referred to or treated in our institution between Jan 1992 and Dec 2013 were retrospectively reviewed. Cox Proportional Hazard Regression Analysis was used to determine the effects of lymphadenectomy and adjuvant radiation as well as other clinicopathological factors on disease free survival and overall survival.</p><p><strong>Results:</strong> Mean age was 59.9 years (range, 45-82). Lymphadenectomy didn't perform in 36 (27.3%) patients and 23 (17.4%) patients did not have any kind of adjuvant treatment. Mean lymph node count was 18.8 (range, 3-67). Federation of Gynecology and Obstetrics grade, lymphovascular space invasion, lymphadenectomy, receiving adjuvant treatment and type of received adjuvant therapy were not associated with disease free survival and overall survival for the entire cohort. In a subgroup of patients with grade1&amp;2 tumor, 5-year disease free survival rates were 80% and 50% (p=0.4), respectively and overall survival rates were 94.8% and 93.8% (p=0.2), respectively for patients who had or didn't have adjuvant radiotherapy. While performance of lymphadenectomy was not significantly associated with disease free survival in this subgroup (p=0.56), this association was statistically significant for overall survival (97.9% vs. 86.4%, p=0.04) <br /><strong></strong></p><p><strong>Conclusion:</strong> Benefit of adjuvant radiotherapy in regard to prevention of recurrence needs to be confirmed by further studies. Lymphadenectomy had a survival benefit for patients with myometrial invasion greater than a half of myometrial thickness.</p>

A Prospective Cohort Study Of Physical Activity In Relation To Disease-free Survival Of Breast Cancer In Women Diagnosed With Breast Cancer

2005 ◽  
Vol 37 (Supplement) ◽  
pp. S358
Author(s):  
Melinda Irwin ◽  
Anne McTiernan ◽  
Rick Baumgartner ◽  
Kathy Baumgartner ◽  
Leslie Bernstein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

scholarly journals Laparoscopic Versus Open Abdominal Radical Hysterectomy for Patients with Endometrial Cancer Involving Cervix

2020 ◽  
Author(s):  
Ming Wang ◽  
Ziyi Zhao ◽  
Xiaohong Xu ◽  
Jinwei Miao ◽  
Weimin Kong ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Radical Hysterectomy ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Laparoscopic Approach ◽  
Hazard Ratio ◽  
Free Survival ◽  
Significant Difference ◽  
Disease Free

Abstract BACKGROUND: Data on the survival outcome between laparoscopic and open abdominal radical hysterectomy is limited in patients with endometrial cancer involving cervix.METHODS: We performed a retrospective 1:1 matched observational study in patients who had their cervix involved by endometrial cancer during the 2010–2018 period in Beijing Obstetrics and Gynecology Hospital in China. All enrolled patients underwent cancer-directed radical hysterectomy through laparoscopic approach or open abdominal surgery and followed until 3 years after the surgery. The primary outcome was the rates of disease-free survival and overall survival.RESULTS: A total of 142 patients were included in the study, 54 patients received laparoscopic surgery and 54 of the remaining 88 patients who received open surgery were selected as control. Overall, the median follow-up duration was 54.22 ± 31.14 months (95%CI: 48.71–59.89 months). There was no difference on the baseline information between two groups, including ages, rates of histologic subtypes, rates of deep myometrial invasion, rates of lymph-node involvement, and postoperative stage. There was no significant difference between the three-year disease-free rates between two groups (3-year rate, 94.3% vs. 92.2%; hazard ratio, 1.36; 95% CI, 0.40 to 4.61). The 3-years rate of overall survival in patients of the laparoscopic group was comparable to patients in the open surgery group (3-year rate, 89.87% vs. 92.14%; hazard ratio for death from any cause, 1.87; 95% CI, 0.60 to5.86).CONCLUSIONS: This study revealed that laparoscopic approach surgery was not associated with shorter disease-free survival and overall survival than open abdominal radical hysterectomy in patients with endometrial cancer involving cervix.

scholarly journals Faktor yang Berpengaruh Terhadap Disease Free Survival dan Overall Survival pada Pasien Kanker Payudara Usia Muda di Kota Padang Tahun 2008 - 2018

2020 ◽  
Vol 9 (1S) ◽  
Author(s):  
Magdi Ayuza ◽  
Wirsma Arif Harahap ◽  
Rony Rustam ◽  
Richvan Dana Nindrea
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Disease Free Survival ◽  
Rank Test ◽  
Free Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Disease Free ◽  
Data Register

Kanker Payudara (KPD) pada usia muda memiliki keistimewaan karakteristik. Rekurensi KPD dipengaruhi oleh berbagai faktor antara lain faktor klinis, regimen terapi dan biomolekuler dari tumor itu sendiri. Berbagai macam modalitas terapi KPD, namun masih terdapat risiko terjadinya rekurensi terutama pada pasien dewasa muda. Tujuan: Mengetahui faktor-faktor yang mempengaruhi Disease Free Survival (DFS) dan Overall Survival (OS) pada pasien KPD usia muda di Kota Padang. Metode: Penelitian ini menggunakan desain cohort study retrospectif pada pasien KPD usia muda yang telah mendapatkan pengobatan KPD yang memenuhi kriteria inklusi sebanyak 103 sample yang terdapat pada data register KPD PERABOI Padang. Analisis survival menggunakan Kaplan Meier dengan Log Rank Test. Apabila diperoleh nilai p < 0,05, maka terdapat hubungan bermakna. Hasil: Terdapat perbedaan antara setiap faktor klinis, faktor biomolekuler dan faktor terapi dalam hal rata-rata DFS maupun rata-rata OS, namun tidak terdapat pengaruh yang bermakna secara analisis statistik antara faktor terapi (terapi hormon, radioterapi dan terapi target) terhadap DFS dan OS pada pasien kanker payudara usia muda di Kota Padang (p>0,05). Terdapat pengaruh dari pemberian kemoterapi terhadap DFS pada pasien kanker payudara usia muda di Kota Padang (p<0,05). Simpulan: Tidak terdapat hubungan yang bermakna antara faktor klinis dan faktor biomolekuler dengan DFS dan OS, namun terdapat hubungan bermakna antara pemberian kemoterapi dengan DFS dan OS pada penderita KPD usia muda di kota Padang tahun 2008 – 2018.

Outcomes and relapse patterns of stage IB grade 2 or 3 endometrial cancer treated with adjuvant vaginal brachytherapy

2019 ◽  
Vol 30 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Alexandra Hochreiter ◽  
Jacqueline R Kelly ◽  
Melissa Rasar Young ◽  
Babak Litkouhi ◽  
Jonathan David Black ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Lower Uterine Segment ◽  
Pelvic Recurrence ◽  
Free Survival ◽  
Stage Ib ◽  
Disease Free

IntroductionRisk factors for pelvic recurrence in early stage endometrial cancer are poorly understood. We sought to describe outcomes, patterns of failure, and risk factors for recurrence among patients with grade 2–3 endometrial cancer with deep myometrial invasion who were treated with vaginal brachytherapy as sole adjuvant therapy after hysterectomy and lymph node dissection.MethodsWe retrospectively reviewed the records of stage I patients with grade 2–3 endometrioid histology and ≥50% myometrial invasion treated at an academic institution from January 2005 to December 2017. Only patients with endometrioid histology were included. Mixed histologies, including papillary serous or clear cell components, were excluded. Further exclusion criteria were International Federation of Gynecology and Obstetrics stage IB grade 1 patients, follow-up time less than 3 months, receipt of pelvic irradiation or any form of systemic therapy (chemotherapy, aromatase inhibitor). Overall survival, disease-free survival, and pelvic recurrence-free survival were calculated with Kaplan–Meier methods. Multivariable Cox proportional hazards regression was used to analyze factors associated with overall survival and disease-free survival.ResultsAmong 131 consecutive patients identified, 111 (85%) patients met the inclusion criteria. The majority (98.2%) underwent lymph node dissection with ≥10 lymph nodes removed in 78.9%. With a median follow-up of 36 months (IQR 12–70 months), the 3-year overall survival, disease-free survival, and pelvic recurrence-free survival were 89.6%, 90.1%, and 92.8%, respectively. Histologic grade 3, older age, and lymphovascular invasion were not associated with inferior outcomes; however, lower uterine segment involvement (p=0.031), tumor size >4 cm (p=0.024), and <10 lymph nodes removed (p=0.032) were associated with reduced disease-free survival on multivariable analysis. Pelvic recurrence occurred in 12 (11%) patients, most often in the setting of synchronous distant disease (n=9), and was significantly more likely with lower uterine segment involvement.ConclusionAmong patients with stage IB grade 2–3 endometrial cancer treated with vaginal brachytherapy, the risk factors for recurrence (larger tumor size and lower uterine segment involvement) in conjunction with established risk factors (high grade, ≥50% myometrial invasion, and lymphovascular invasion) may identify a group of high-risk patients who might benefit from pelvic radiotherapy.

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

Impact of non-compliance with guidelines in early type 1 endometrial cancers management, study from FRANCOGYN group.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5587-5587
Author(s):  
Hélène Costaz ◽  
Sofiane Bendifallah ◽  
Emilie Raimond ◽  
Clémentine Jankowski ◽  
Sabrina Dridi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Disease Free Survival ◽  
Early Type ◽  
Free Survival ◽  
Significant Difference ◽  
Endometrial Cancers ◽  
The Impact ◽  
Disease Free

5587 Background: To standardize surgical practices, ESMO-ESGO-ESTRO consensus conference published in 2016 new guidelines on the management of endometrial cancer. The main objective of this study was to evaluate the impact of non-compliance with current surgical guidelines on disease-free survival and overall survival. Methods: 852 patients with presumptive stage I and II type 1 endometrial cancer were included in a multicenter retrospective study, conducted between January 2000 and November 2015. The main objective of this study was to evaluate the impact of non-compliance with current surgical recommendations on overall survival and disease-free survival. Results: Our study shows that 34.3% of patients (n = 292) did not benefit from optimal surgical treatment. These patients did not have a lombo-aortic lymphadenectomy (LAL) and were at high risk of recurrence. There is a significant difference in disease-free survival in favor of patients undergoing surgery according to the recommendations, (Hazard Ratio (HR): 0.37 (Confidence interval (95% CI): 0.26-0.54), p < 0.001). In multivariate analysis, optimal surgical procedure performance is an independent factor for disease-free survival with HR at 2.04 (95% CI: 1.14-3.68), p = 0.01. There is a significant difference in overall survival in favor of patients undergoing surgery according to the recommendations, (HR: 0.31 (95% CI): 0.19-0.49), p < 0.001. In multivariate analysis, there is a trend toward significance with HR: 2.24 (95% CI: 1-5.05), p = 0.05. Older patients, patients with a larger BMI, patients with no indication of LAL at the preoperative ESMO classification, and no node involvement in are factors contributing to the decision of not to perform a LAL: p < 0.001, p = 0.03, p < 0.001 and p < 0.001 respectively. Conclusions: This study shows that patients with early type 1 endometrial cancer have improved recurrence-free survival and a statistical trend for an increased overall survival when recommended surgery is performed. Despite the current context of therapeutic de-escalation, we must strive to achieve the recommended optimal surgery, even if it requires secondary surgical revision, to avoid underestimation of patients with a poorer prognosis. To improve endometrial cancers management, amelioration of the preoperative assessment by increasing the sensitivity of emboli detection should be considered.

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