The Prognostic Significance of the Depth of Cervical Stromal Invasion in Women With FIGO Stage II Uterine Endometrioid Carcinoma.
Journal
American journal of clinical oncology
ISSN: 1537-453X
Titre abrégé: Am J Clin Oncol
Pays: United States
ID NLM: 8207754
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
medline:
26
9
2023
pubmed:
1
8
2023
entrez:
1
8
2023
Statut:
ppublish
Résumé
The objective of this study was to investigate the prognostic significance of the depth of cervical stromal invasion (CSI) in women with FIGO stage II uterine endometrioid adenocarcinoma (EC). Our database of women with EC was quired for patients with stage II EC. Pathologic slides were retrieved and reviewed by gynecologic pathologists to determine cervical stromal thickness and depth of CSI as a percentage of stromal thickness (%CSI). Kaplan-Meier, univariate, and multivariate analyses were used to compare recurrence-free, disease-specific (DSS), and overall survival (OS) between women who had<50% versus ≥50% CSI. Univariate and multivariate analyses were used to assess other prognostic variables associated with survival endpoints. A total of 117 patients were included in our study who had hysterectomy between 1/1990 and 8/2021. Seventy-nine patients (68%) with <50% and 38 (32w%) with ≥50% CSI. After a median follow-up of 131 months, 5-year DSS was significantly worse for women with ≥50% CSI (78% vs. 91%; P =0.04). However, %CSI was not an independent predictor for any of the studied survival endpoints. Independent predictors of worse 5-year recurrence-free survival and DSS included FIGO grade 3 tumors ( P =0.02) and the presence of lymphovascular space invasion ( P =0.03). Grade 3 tumors were the only independent predictor of worse 5-year OS ( P =0.02). Our results suggest that deep CSI is not an independent prognostic factor for survival endpoints in women with stage II uterine endometroid adenocarcinoma. The lack of independent prognostic significance of the depth CSI needs to be validated in a multi-institutional analysis.
Identifiants
pubmed: 37525355
doi: 10.1097/COC.0000000000001033
pii: 00000421-990000000-00118
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
445-449Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Creasman WT, Odicino F, Maisonneuve P, et al. Carcinoma of the corpus uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006;95 (suppl 1):S105–S143.
Creasman W. Revised FIGO staging for carcinoma of the endometrium. Int J Gynaecol Obstet. 2009;105:109.
Chen KS, Berhane H, Gill BS, et al. Outcomes of stage II endometrial cancer: the UPMC Hillman Cancer Center experience. Gynecol Oncol. 2017;147:315–319.
Ferriss JS, Brix W, Tambouret R, et al. Cervical stromal invasion predicting survival in endometrial cancer. Obstet Gynecol. 2010;116:1035–1041.
Barnes EA, Parra-Herran C, Martell K, et al. Vaginal brachytherapy alone for patients with Stage II endometrial cancer with inner half cervical stromal invasion. Brachytherapy. 2019;18:606–611.
Orezzoli JP, Sioletic S, Olawaiye A, et al. Stage II endometrioid adenocarcinoma of the endometrium: clinical implications of cervical stromal invasion. Gynecol Oncol. 2009;113:316–323.
Harkenrider MM, Martin B, Nieto K, et al. Multi-institutional analysis of vaginal brachytherapy alone for women with stage II endometrial carcinoma. Int J Radiat Oncol Biol Phys. 2018;101:1069–1077.
Elshaikh MA, Al-Wahab Z, Mahdi H, et al. Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma: a multi-institution study. Gynecol Oncol. 2015;136:235–239.
Harkenrider MM, Abu-Rustum N, Albuquerque K, et al. Radiation therapy for endometrial cancer: an ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2023;13:41–65.
Narasimhulu DM, Cope A, Riaz IB, et al. External beam radiotherapy versus vaginal brachytherapy in patients with stage II endometrial cancer: a systematic review and meta-analysis. Int J Gynecol Cancer. 2020;30:797–805.
Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105:103–104.
Ng TY, Nicklin JL, Perrin LC, et al. Postoperative vaginal vault brachytherapy for node-negative Stage II (occult) endometrial carcinoma. Gynecol Oncol. 2001;81:193–195.
Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Radiother Oncol. 2021;154:327–353.
Abu-Rustum NR, Yashar Cm, Bradley K, et al. Uterine neoplasms 2022. https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf
Cattaneo R 2nd, Hanna RK, Jacobsen G, et al. Interval between hysterectomy and start of radiation treatment is predictive of recurrence in patients with endometrial carcinoma. Int J Radiat Oncol Biol Phys . 2014;88:866–871.
Fabrini MG, Gadducci A, Perrone F, et al. Relationship between interval from surgery to radiotherapy and local recurrence rate in patients with endometrioid-type endometrial cancer: a retrospective mono-institutional Italian study. Anticancer Res. 2012;32:169–173.
Eltabbakh GH, Moore AD. Survival of women with surgical stage II endometrial cancer. Gynecol Oncol. 1999;74:80–85.
Cuccu I, D’Oria O, Sgamba L, et al. Role of genomic and molecular biology in the modulation of the treatment of endometrial cancer: narrative review and perspectives. Healthcare. 2023;11:571.
Kandoth C, Schultz N, Cherniack AD, et al. Integrated genomic characterization of endometrial carcinoma. Nature . 2013;497:67–73.
Leon-Castillo A, Horeweg N, Peters EEM, et al. Prognostic relevance of the molecular classification in high-grade endometrial cancer for patients staged by lymphadenectomy and without adjuvant treatment. Gynecol Oncol. 2022;164:577–586.
Kommoss S, McConechy MK, Kommoss F, et al. Final validation of the ProMisE molecular classifier for endometrial carcinoma in a large population-based case series. Ann Oncol. 2018;29:1180–1188.
Da Cruz Paula A, DeLair DF, Ferrando L, et al. Genetic and molecular subtype heterogeneity in newly diagnosed early- and advanced-stage endometrial cancer. Gynecol Oncol. 2021;161:535–544.
Stelloo E, Nout RA, Osse EM, et al. Improved risk assessment by integrating molecular and clinicopathological factors in early-stage endometrial cancer-combined analysis of the PORTEC Cohorts. Clin Cancer Res. 2016;22:4215–4224.
Church DN, Stelloo E, Nout RA, et al. Prognostic significance of POLE proofreading mutations in endometrial cancer. J Natl Cancer Inst. 2015;107:402.
van den Heerik A, Horeweg N, Nout RA, et al. PORTEC-4a: international randomized trial of molecular profile-based adjuvant treatment for women with high-intermediate risk endometrial cancer. Int J Gynecol Cancer. 2020;30:2002–2007.