TY - JOUR
T1 - Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma
T2 - A multi-institution study
AU - Elshaikh, Mohamed A.
AU - Al-Wahab, Zaid
AU - Mahdi, Haider
AU - Albuquerque, Kevin
AU - Mahan, Meredith
AU - Kehoe, Siobhan M.
AU - Ali-Fehmi, Rouba
AU - Rose, Peter G.
AU - Munkarah, Adnan R.
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Objective. There is paucity of data in regard to prognostic factors and outcome of women with 2009 FIGO stage II disease. The objective of this study was to investigate prognostic factors, recurrence patterns and survival endpoints in this group of patients. Methods. Data from four academic institutions were analyzed. 130 women were identified with 2009 FIGO stage II. All patients underwent hysterectomy, oophorectomy and lymph node evaluation with or without pelvic and paraaortic lymph node dissections and peritoneal cytology. The Kaplan-Meier approach and Cox regression analysis were used to estimate recurrence-free (RFS), disease-specific (DSS) and overall survival (OS). Results. Median follow-up was 44 months. 120 patients (92%) underwent simple hysterectomy, 78% had lymph node dissection and 95% had peritoneal cytology examination. 99 patients (76%) received adjuvant radiation treatment (RT). 5-year RFS, DSS and OS were 77%, 90%, and 72%, respectively. On multivariate analysis of RFS, adjuvant RT, the presence of lymphovascular space invasion (LVSI) and high tumor grades were significant predictors. For DSS, LVSI and high tumor grades were significant predictors while older age and high tumor grade were the only predictors of OS. Conclusions. In this multi-institutional study, disease-specific survival for women with FIGO stage II uterine endometrioid carcinoma is excellent. High tumor grade, lymphovascular space invasion, adjuvant radiation treatment and old age are important prognostic factors. There was no significant difference in the outcome between patients who received vaginal cuff brachytherapy compared to those who received pelvic external beam radiation treatment.
AB - Objective. There is paucity of data in regard to prognostic factors and outcome of women with 2009 FIGO stage II disease. The objective of this study was to investigate prognostic factors, recurrence patterns and survival endpoints in this group of patients. Methods. Data from four academic institutions were analyzed. 130 women were identified with 2009 FIGO stage II. All patients underwent hysterectomy, oophorectomy and lymph node evaluation with or without pelvic and paraaortic lymph node dissections and peritoneal cytology. The Kaplan-Meier approach and Cox regression analysis were used to estimate recurrence-free (RFS), disease-specific (DSS) and overall survival (OS). Results. Median follow-up was 44 months. 120 patients (92%) underwent simple hysterectomy, 78% had lymph node dissection and 95% had peritoneal cytology examination. 99 patients (76%) received adjuvant radiation treatment (RT). 5-year RFS, DSS and OS were 77%, 90%, and 72%, respectively. On multivariate analysis of RFS, adjuvant RT, the presence of lymphovascular space invasion (LVSI) and high tumor grades were significant predictors. For DSS, LVSI and high tumor grades were significant predictors while older age and high tumor grade were the only predictors of OS. Conclusions. In this multi-institutional study, disease-specific survival for women with FIGO stage II uterine endometrioid carcinoma is excellent. High tumor grade, lymphovascular space invasion, adjuvant radiation treatment and old age are important prognostic factors. There was no significant difference in the outcome between patients who received vaginal cuff brachytherapy compared to those who received pelvic external beam radiation treatment.
KW - Brachytherapy
KW - Endometrial carcinoma
KW - Hysterectomy
KW - Prognosis
KW - Recurrence
KW - Stage II
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U2 - 10.1016/j.ygyno.2014.12.012
DO - 10.1016/j.ygyno.2014.12.012
M3 - Article
C2 - 25511158
AN - SCOPUS:84922986152
SN - 0090-8258
VL - 136
SP - 235
EP - 239
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -