A validation study of a scoring system to estimate the risk of lymph node metastasis for patients with endometrial carcinoma for tailoring the indication of lymphadenectomy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5040-5040
Author(s):  
Y. Todo ◽  
Y. Ebina ◽  
H. Watari ◽  
N. Sakuragi
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastasis ◽  
Endometrial Carcinoma ◽  
Validation Study ◽  
Risk Group ◽  
Tumor Grade ◽  
High Risk Group ◽  
Volume Index ◽  
Node Metastasis

5040 Background: The present standard treatment for cases with endometrial cancer is surgical staging including lymphadenectomy. Elimination of lymphadenectomy will not be approved of unless strict condition are met. Our aim is to verify whether a preoperative scoring system to estimate the risk of lymph node metastasis (LNM) in endometrial carcinoma is clinically useful for tailoring the indication of lymphadenectomy. Methods: This study was carried out on 211 patients with endometrial carcinoma for whom volume index, serum CA125 level, tumor grade/histology were preoperatively confirmed. LNM score was set up using these three risk factors as reported in our previous study (Am J Obstet Gynecol 2003). We analyzed whether these factors remain still valid in a different cohort of patients. Based on the LNM score before a validation study was started, the estimated rate of lymph node metastasis (para-aortic lymph node metastasis) in a low risk group was 3.4% (0.0%), an intermediate group 7.7% (5.8%), a high risk group 44.4% (30.6%) and an extremely high risk group 70.0% (50.0%). Results: Volume index, serum CA125 level, and tumor grade/histology, were found to be independent risk factors for LNM in the cohort of this validation study. The actual rate of lymph node metastasis (para-aortic lymph node metastasis) in a low risk group was 3.2% (1.0%), an intermediate group 15.3% (11.9%), a high risk group 30.2% (23.8%) and an extremely high risk group 78.6% (57.1%). Conclusions: LNM frequencies increased in proportion to the impact of the LNM score and the actual rate of lymph node metastasis for each score was quite consistent with the estimated rate of lymph node metastasis.Our LNM score for patients with endometrial carcinoma is useful. No significant financial relationships to disclose.

Development and validation of a six-gene signature for predicting prognosis in prostate cancer patients with lymph node metastasis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17524-e17524
Author(s):  
Jinan Guo ◽  
Wenzhuan Xie ◽  
Mengli Huang ◽  
Chan Gao
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastasis ◽  
Cox Regression ◽  
Risk Group ◽  
Gene Signature ◽  
High Risk Group ◽  
Wild Type ◽  
Cox Regression Analysis ◽  
Node Metastasis

e17524 Background: Prostate cancer (PCa) patients with lymph node metastasis (LNM) always exhibit poor clinical outcomes. A gene signature that could predict survival in these patients would allow for earlier detection of mortality risk and will also guide individualized therapy. Methods: A prediction model was developed using a public cohort consisting of 623 patients with clinicopathologically confirmed PCa. Data were gathered from cBioPortal and UCSC Xena. Genes expressed differentially in patients with lymph node metastasis versus those without lymph node metastasis were identified. Uni-variate Cox regression analysis and LASSO Cox regression were applied to build a prediction model. Time-dependent receiver operating characteristic (ROC) and Kaplan-Meier curves were used to assess the prognostic capacity of the model, followed by external validation using the MSKCC dataset from cBioPortal. Gene Set Enrichment Analysis (GSEA) was performed to further understand the underlying molecular mechanisms. Results: We identified a six-gene signature (covering GSDMB, SSTR1, MX1, CCBE1, MYBPC1, and FAM3D) that could effectively identify a high-risk subset of PCa patients. ROC analysis indicated that the signature had a good performance (AUC > 0.7) in survival prediction in both the training and the testing/validation cohorts. Cox regression analysis showed that the six-gene signature could independently predict disease-free survival (DFS) as well, although with lower predictive power. Subgroup analyses showed that signature-based risk score may serve as a promising marker to predict DFS in different subgroups, including stage T2 (HR = 0.12, p < 0.001), stage T3 (HR = 0.29, p < 0.001), TP53-wild-type (HR = 0.22, p < 0.001), TP53-mutated (HR = 0.07, p < 0001), AR pathways-wild-type (HR = 0.2, p < 0.001) and AR pathways-mutated(HR = 0.16, p = 0.0419). The performance of the six-gene signature in LNM+ was stable for stratifying the patients according to risk of deatch (HR = 0.23, p = 0.0333). Moreover, GSEA revealed distinct pathway enrichment features in the different risk groups, where pathways related to DNA repair were more prominently enriched in the high-risk group while the low-risk group had higher enrichment of androgen response. Conclusions: We developed a robust six-gene signature that can effectively classify PCa patients into groups with low- and high-risk group, which may help select high-risk patients who require more aggressive adjuvant target therapy or immune therapy.

Influence of preoperative irradiation on failures of endometrial carcinoma with high risk of lymph node metastasis

1984 ◽  
Vol 7 (6) ◽  
pp. 661-668 ◽  
Author(s):  
Ritsuko Komaki ◽  
James D. Cox ◽  
Arthur Hartz ◽  
J. Frank Wilson ◽  
Maurice Greenberg
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastasis ◽  
Endometrial Carcinoma ◽  
Preoperative Irradiation ◽  
Node Metastasis

The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology

2008 ◽  
Vol 18 (2) ◽  
pp. 269-273 ◽  
Author(s):  
D. S. Chi ◽  
R. R. Barakat ◽  
M. J. Palayekar ◽  
D. A. Levine ◽  
Y. Sonoda ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Pelvic Lymph Node ◽  
Study Cohort ◽  
Node Metastasis ◽  
Figo Staging ◽  
Pelvic Lymph Node Metastasis

The seminal Gynecologic Oncology Group study on surgical pathologic spread patterns of endometrial cancer demonstrated the risk of pelvic lymph node metastasis for clinical stage I endometrial cancer based on tumor grade and thirds of myometrial invasion. However, the FIGO staging system assigns surgical stage by categorizing depth of myometrial invasion in halves. The objective of this study was to determine the incidence of pelvic lymph node metastasis in endometrial cancer based on tumor grade and myometrial invasion as per the current FIGO staging system. We reviewed the records of all patients who underwent primary surgical staging for clinical stage I endometrial cancer at our institution between May 1993 and November 2005. To make the study cohort as homogeneous as possible, we included only cases of endometrioid histology. We also included only patients who had adequate staging, which was defined as a total hysterectomy with removal of at least eight pelvic lymph nodes. During the study period, 1036 patients underwent primary surgery for endometrial cancer. The study cohort was composed of the 349 patients who met study inclusion criteria. Distribution of tumor grade was as follows: grade 1, 80 (23%); grade 2, 182 (52%); and grade 3, 87 (25%). Overall, 30 patients (9%) had pelvic lymph node metastasis. The incidence of pelvic lymph node metastasis in relation to tumor grade and depth of myometrial invasion (none, inner half, and outer half) was as follows: grade 1–0%, 0%, and 0%, respectively; grade 2–4%, 10%, and 17%, respectively; and grade 3–0%, 7%, and 28%, respectively. We determined the incidence of pelvic nodal metastasis in a large cohort of endometrial cancer patients of uniform histologic subtype in relation to tumor grade and a one-half myometrial invasion cutoff. These data are more applicable to current surgical practice than the previously described one-third myometrial invasion cutoff results.

The prominent value of apparent diffusion coefficient in assessing high-risk factors and prognosis for patients with endometrial carcinoma before treatment

2020 ◽  
pp. 028418512094027
Author(s):  
Quan Quan ◽  
Yunfeng Lu ◽  
Beibei Xuan ◽  
Jingxian Wu ◽  
Wanchun Yin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diffusion Coefficient ◽  
Lymph Node ◽  
High Risk ◽  
Lymph Node Metastasis ◽  
Apparent Diffusion Coefficient ◽  
Treatment Schedule ◽  
Node Metastasis ◽  
High Risk Factors ◽  
Apparent Diffusion

Background To date, there are no consensus methods to evaluate the high-risk factors and prognosis for managing the personalized treatment schedule of patients with endometrial carcinoma (EC) before treatment. Apparent diffusion coefficient (ADC) is regarded as a kind of technique to assess heterogeneity of malignant tumor. Purpose To explore the role of ADC value in assessing the high-risk factors and prognosis of EC. Material and Methods A retrospective analysis was made on 185 patients with EC who underwent 1.5-T magnetic resonance imaging (MRI). Mean ADC (mADC), minimum ADC (minADC), and maximum ADC (maxADC) were measured and compared in different groups. Results Among the 185 patients with EC, the mADC and maxADC values in those with high-risk factors (type 2, deep myometrial invasion, and lymph node metastasis) were significantly lower than in those without. According to receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were significant for mADC, minADC, and maxADC predicting high-risk factors. Furthermore, the AUCs were significant for mADC and maxADC predicting lymph node metastasis but were not significant for minADC. Patients with lower mADC were associated with worse overall survival and disease-free survival; the opposite was true for patients with higher mADC. Conclusion Our study showed that ADC values could be applied to assess the high-risk factors of EC before treatment and might significantly relate to the prognosis of EC. It might contribute to managing initial individualized treatment schedule and improve outcome in patients with EC.

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