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

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.

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

Tumori Journal ◽

10.1177/030089168306900111 ◽

1983 ◽

Vol 69 (1) ◽

pp. 65-67 ◽

Cited By ~ 4

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.

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

Cancer Imaging ◽

10.1186/s40644-021-00420-8 ◽

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.

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

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1994.04050352.x ◽

1994 ◽

Vol 4 (5) ◽

pp. 352-355 ◽

Cited By ~ 16

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.

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

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v20i3.1737 ◽

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.

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

BMC Cancer ◽

10.1186/s12885-021-08988-x ◽

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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Prognostic factors and sites of failure in figo Stage I, Grade 3 endometrial carcinoma

Gynecologic Oncology ◽

10.1016/0090-8258(87)90291-5 ◽

1987 ◽

Vol 27 (2) ◽

pp. 180-188 ◽

Cited By ~ 29

Author(s):

Setsuko K. Chambers ◽

Daniel S. Kapp ◽

Richard E. Peschel ◽

Roberta Lawrence ◽

Maria Merino ◽

...

Keyword(s):

Prognostic Factors ◽

Endometrial Carcinoma ◽

Figo Stage ◽

Stage I ◽

Grade 3

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Preoperative predictive factor analysis of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma

10.21203/rs.2.17501/v2 ◽

2020 ◽

Author(s):

Qin Chen ◽

Yan Feng ◽

Wenwen Wang ◽

Weiguo Lv ◽

Baohua Li

Keyword(s):

Endometrial Carcinoma ◽

Clinical Stage ◽

Myometrial Invasion ◽

Stage I ◽

Preoperative Imaging ◽

Invasion Depth ◽

Ca125 Level ◽

Serum Ca125 ◽

Premenopausal Patients ◽

Endometrioid Endometrial Carcinoma

Abstract Background Earlier literature suggests that ovarian preservation in young premenopausal clinical stage I endometrioid endometrial carcinoma patients does not negatively impact prognosis and is a more suitable choice for management of the disease. The main purpose of this study was to clarify the incidence of ovarian malignant involvement in premenopausal clinical stage I endometrioid endometrial carcinoma and further identify potential preoperative predictive factors of ovarian malignant involvement. Methods Premenopausal patients (≤50 years) with clinical stage I endometrioid endometrial carcinoma subjected to total hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and/or para-aortic lymph node dissection at Women’s Hospital, Zhejiang University School of Medicine between 2002 and 2016 were enrolled for study. Patients were excluded in cases of gross extra pelvic disease on examination or imaging and family history of colon or gastrointestinal carcinoma. The included patient population was examined for incidence of ovarian malignant involvement and potential preoperative clinical predictive factors.Results A total of 511 premenopausal (age≤50 years) patients diagnosed with clinical stage I endometrioid endometrial carcinoma were enrolled for the study. Ovarian malignant involvements were detected in 23 of the patients (4.5%). Kaplan-Meier analysis showed poorer prognoses of patients with ovarian malignant involvement than those without ovarian involvement. Univariate and multivariate logistic analysis validated preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and preoperative serum carbohydrate antigen 125 (CA125) level as independent risk predictors of postoperative ovarian malignant involvement. Receiver operating characteristic (ROC) curves was individually generated for preoperative myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level as well as a combination of the three factors. The area under curve (AUC) was 0.858 (95% confidence interval [CI], 0.757–0.960) for the combined three factors.Conclusions The incidence of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma was relatively minimal. Preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level were independent risk predictors of ovarian malignant involvement. These findings may facilitate preoperative counseling of patients and informed clinical decision-making on ovarian preservation in these patients.

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