Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma: A multi-institution study

Mohamed A. Elshaikh, Zaid Al-Wahab, Haider Mahdi, Kevin Albuquerque, Meredith Mahan, Siobhan M. Kehoe, Rouba Ali-Fehmi, Peter G. Rose, Adnan R. Munkarah

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)235-239
Number of pages5
JournalGynecologic Oncology
Volume136
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Endometrioid Carcinoma
Recurrence
Survival
Radiation
Lymph Node Excision
Hysterectomy
Cell Biology
Neoplasms
Brachytherapy
Ovariectomy
Therapeutics
Multivariate Analysis
Lymph Nodes
Regression Analysis

Keywords

  • Brachytherapy
  • Endometrial carcinoma
  • Hysterectomy
  • Prognosis
  • Recurrence
  • Stage II

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma : A multi-institution study. / Elshaikh, Mohamed A.; Al-Wahab, Zaid; Mahdi, Haider; Albuquerque, Kevin; Mahan, Meredith; Kehoe, Siobhan M.; Ali-Fehmi, Rouba; Rose, Peter G.; Munkarah, Adnan R.

In: Gynecologic Oncology, Vol. 136, No. 2, 01.02.2015, p. 235-239.

Research output: Contribution to journalArticle

Elshaikh, Mohamed A. ; Al-Wahab, Zaid ; Mahdi, Haider ; Albuquerque, Kevin ; Mahan, Meredith ; Kehoe, Siobhan M. ; Ali-Fehmi, Rouba ; Rose, Peter G. ; Munkarah, Adnan R. / Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma : A multi-institution study. In: Gynecologic Oncology. 2015 ; Vol. 136, No. 2. pp. 235-239.
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abstract = "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.",
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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.

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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