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Original Research

Open Access

Prognostic factors determining recurrence in early-stage endometrial cancer

  • S. Misirlioglu1
  • A.B. Guzel1,*,
  • U.K. Gulec1
  • D. Gumurdulu2
  • M.A. Vardar1

1Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Adana, Turkey

2Department of Pathology, Faculty of Medicine, Cukurova University, Adana, Turkey

DOI: 10.12892/ejgo201206610 Vol.33,Issue 6,November 2012 pp.610-614

Published: 10 November 2012

*Corresponding Author(s): A.B. Guzel E-mail: abguzel@gmail.com

Abstract

Objective: This study aimed to determine the clinically important prognostic factors for loco-regional or distant recurrence in early-stage endometrial cancer. Materials and Methods: This study complied with the Declaration of Helsinki, and the local ethics committee approved the study: Cases who underwent primary surgery of early-stage endometrial cancer at the Institution from 2000 to 2012 were reviewed retrospectively. Patients who did not detect recurrence were classified as group 1 (n = 200); those who detected recurrence were classified as group 2 (n = 23). Clinically prognostic factors were evaluated by univariate analyses. Results: The average age for group 2 (LUSI) was 63.8 years (p = 0.0001). Patients with grade 3 histology were all detected within group 2 (p = 0.0001). Endometrioid adenocarcinoma displaying squamous differentiation was found with a rate of 58.3% in group 2 (p = 0.0001). Lower uterine segment involvement (LUSI) and lymphovascular space invasion (LVSI) rates were 86.9% in group 2 (p = 0.0001). The rate of tumor size > 2 cm was 56.6% in group 2 (p = 0.0001). The median depth of myometrial invasion (DMI) was 5.1 mm (p = 0.034) and the average in myometrial thickness was 14.5 mm in group H (p = 0.0001). The percentage of myometrial invasion was 35.8% in Group II (p = 0.0001). Tumor free-distance was 9.4 mm in group II (p = 0.0001). Conclusion: Age and clinicopathological parameters of the tumours are significant predictors for recurrence in early-stage endometrial cancer.

Keywords

Early-stage endometrial cancer; Prognostic factors; Recurrence

Cite and Share

S. Misirlioglu,A.B. Guzel,U.K. Gulec,D. Gumurdulu,M.A. Vardar. Prognostic factors determining recurrence in early-stage endometrial cancer. European Journal of Gynaecological Oncology. 2012. 33(6);610-614.

References

[1] Jemal A., Siegel R., Xu J., Ward E.: CA Cancer J. Clin., 2011, 61, 133.

[2] American Cancer Society. Cancer facts and figures 2010 [Internet]. Atlanta, GA: American Cancer Society;©2011 [cited2011, Feb20]. Availablefrom:http://www.cancer.org/Research/Cancer-FactsFigures/CancerFactsFigures/ cancer-facts-and-figures-2010.

[3] Keller D., Kempson R.L., Levine G. et al.: “Management of the patient with early endometrial carcinoma”. Cancer, 1974, 33, 1108.

[4] Jeong N.H., Lee J.M., Lee S.K.: “Current status in the management of uterine corpus cancer in Korea”. J. Gynecol. Oncol., 2010, 21, 151.

[5] Salani R., Nagel C.I., Drennen E., Bristow R.E.: “Recurrence patterns and surveillance for patients with early stage endometrial cancer”. Gynecol. Oncol., 2011, 123, 205.

[6] Otsuka I., Uno M., Wakabayashi A., Kameda S., Udagawa H., Kubota T.: “Predictive factors for prolonged survival in recurrent endometrial carcinoma: Implications for follow-up protocol”. Gynecol. Oncol., 2010, 119, 506.

[7] Prat J.: “Prognostic parameters of endometrial carcinoma”. Hum. Pathol., 2004, 35, 649.

[8] Fung-Kee-Fung M., Dodge J., Elit L., Lukka H., Chambers A., Oliver T.: “Follow-up after primary therapy for endometrial cancer: a systematic review”. Gynecol. Oncol., 2006, 101, 520.

[9] van Wijk F.H., van der Burg M.E., Burger C.W. et al.: “Management of recurrent endometrioid endometrial carcinoma: an overview”. Int. J. Gynecol. Cancer, 2009, 19, 314.

[10] Fujimoto T., Nanjyo H., Fukuda J. et al.. “Endometrioid uterine cancer: histopathological risk factors of local and distant recurrence”. Gynecol. Oncol., 2009, 112, 342.

[11] Mariani A., Webb M.J., Keeney G.L. et al.: “Surgical Stage I endometrial cancer: predictors of distant failure and death”. Gynecol. Oncol., 2002, 87, 274.

[12] Creutzberg C.L., van Putten W.L., Koper P.C. et al.: “Surgery and postoperative radiotherapy versus surgery alone for patients with Stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma”. Lancet, 2000, 355, 1404.

[13] Creutzberg C.L., van Putten W.L., Koper P.C. et al.: “Survival after relapse in patients with endometrial cancer: results from a randomized trial”. Gynecol. Oncol., 2003, 89, 201.

[14] Keys H.M., Roberts J.A., Brunetto V.L. et al.: “A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study”. Gynecol. Oncol., 2004, 92, 744.

[15] Morrow C.P., Bundy B.N., Kurman R.J. et al.: “Relationship between surgical-pathological risk factors and outcome in clinical Stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study”. Gynecol. Oncol., 1991, 40, 55.

[16] Descamps P., Calais G., Moire C., Bertrand P., Castiel M., Le F.O. et al.: “Predictors of distant recurrence in clinical Stage I or II endometrial carcinoma treated by combination surgical and radiation therapy”. Gynecol. Oncol., 1997, 64, 548.

[17] Kuten A., Grigsby P.W., Perez C.A., Fineberg B., Garcia D.M., Simpson J.R.: “Results of radiotherapy in recurrent endometrial carcinoma: a retrospective analysis of 51 patients”. Int. J. Radiat. Oncol. Biol. Phys., 1989, 17, 29.

[18] Zusterzeel P.L., Bekkers R.L., Hendriks J.C., Neesham D.N., Rome R.M., Quinn M.A.: “Prognostic factors for recurrence in patients with FIGO Stage I and Prognostic factors for recurrence in patients with FIGO Stage I and II, intermediate or high risk endometrial cancer”. Acta Obstet. Gynecol. Scand., 2008, 87, 240.

[19] Mundt A.J., Waggoner S., Yamada D., Rotmensch J., Connell P.P.: “Age as a prognostic factor for recurrence in patients with endometrial carcinoma”. Gynecol. Oncol., 2000, 79, 79.

[20] Zaino R.J., Kurman R.J., Diana K.L., Morrow C.P.: “Pathologic models to predict outcome for women with endometrial adenocarcinoma: the importance of the distinction between surgical stage and clinical stage a Gynecologic Oncology Group study”. Cancer, 1996, 77, 1115.

[21] Kwon J.S., Carey M.S., Cook E.F., Qiu F., Paszat L.: “Patterns of practice and outcomes in intermediate- and high-risk Stage I and II endometrial cancer: a population-based study”. Int. J. Gynecol. Cancer, 2007, 17, 433.

[22] Lavie O., Uriev L., Gdalevich M., Barak F., Peer G., Auslender R., Anteby E., Gemer O.: “The outcome of patients with Stage I endometrial cancer involving the lower uterine segment”. Int. J. Gynecol. Cancer, 2008, 18, 1079.

[23] Gemer O., Gdalevich M., Voldarsky M., Barak F., Ben Arie A., Schneider D., Levy T., Anteby E.Y., Lavie O.: “Lower uterine segment involvement is associated with adverse outcome in patients with stage I endometroid endometrial cancer: results of a multicenter study”. Eur. J. Surg. Oncol., 2009, 35, 865.

[24] Gemer O., Arie A.B., Levy T., Gdalevich M., Lorian M., Barak F., Anteby E., Lavie O.: “Lymphvascular space involvement compromises the survival of patients with Stage I endometrial cancer: Results of a multicenter study”. Eur. J. Surg. Oncol., 2007, 33, 644.

[25] Briët J.M., Hollema H., Reesink N., Aalders J.G., Mourits M.J., ten Hoor K.A. et al.: “Lymphovascular space involvement: An independent prognostic factor in endometrial cancer”. Gynecol. Oncol., 2005, 96, 799.

[26] Cheewakriangkrai C., Panggid K., Siriaungkul S., Khunamornpong S., Suprasert P., Srisomboon J.: “Lymphovascular space invasion as a prognostic determinant in uterine cancer”. Asian Pac. J. Cancer Prev., 2007, 8, 363.

[27] Shah C., Johnson E.B., Everett E., Tamimi H., Greer B., Swisher E. et al.: “Does size matter? Tumor size and morphology as predictors of nodal status and recurrence in endometrial cancer”. Gynecol. Oncol., 2005, 99, 564.

[28] Lindauer J., Fowler J.M., Manolitsas T.P., Copeland L.J., Eaton L.A., Ramirez N.C. et al.: “Is there a prognostic difference between depth of myometrial invasion and the tumor-free distance from the uterine serosa in endometrial cancer”. Gynecol. Oncol., 2003, 91, 547.

[29] Schwab K.V., O’Malley D.M., Fowler J.M., Copeland L.J., Cohn D.E.: “Prospective evaluation of prognostic significance of the tumor-free distance from uterine serosa in surgically staged endometrial adenocarcinoma”. Gynecol. Oncol., 2009, 112, 146.

[30] Kondalsamy-Chennakesavan S., van Vugt S., Sanday K., Nicklin J., Land R., Perrin L. et al.: “Evaluation of tumor-free distance and depth of myometrial invasion as prognostic factors for lymph node metastases in endometrial cancer”. Int. J. Gynecol. Cancer, 2010, 20, 1217.

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