Baseline risk of recurrence in stage I–II endometrial carcinoma

Abstract

ObjectiveThough there are no evidences that postoperative therapy improves overall survival (OS) in stage I–II endometrial carcinoma, many women receive postoperative radiation or chemotherapy. This study aimed to investigate the baseline risk of recurrence after complete resection without any adjuvant therapies and to suppose the validity of postoperative therapy for stage I–II endometrial carcinoma.MethodsCharts for patients with stage I–II endometrial carcinoma who underwent operation without postoperative therapy between January 2005 and December 2011 were retrospectively reviewed and the baseline risk of recurrence and prognosis were assessed. Risk classifications were performed according to European Society for Medical Oncology (ESMO) clinical practice guidelines and Japanese guideline written by Japan Society of Gynecologic Oncology Group.ResultsAmong 374 patients who underwent complete resection, 311 were evaluable. Five-year recurrence rates by ESMO and Japanese were 2.6% and 3.1% in low-risk, 9.2% and 6.6% in intermediate-risk and 13.5% and 13.8% in high-risk group (p=0.003 and 0.015, respectively). High-risk group had worse OS compared with low- and intermediate-risk groups (5-year OS, low: 97.9% and 97.6%, intermediate: 97.9% and 98.8%, and high: 89.5% and 87.5%; p=0.003 and 0.008, respectively). Independent predictive factors of recurrence were age over 60 years, type 2 (estrogen-independent) and peritoneal cytology.ConclusionESMO and Japanese risk classification similarly stratify the baseline risk of recurrence. Patients with stage I–II endometrial carcinoma, especially low- and intermediate-risk diseases, have low recurrence rate and favorable OS, and the benefit of postoperative therapy might be small.

Retrospective detection of isolated tumor cells by immunohistochemistry in sentinel lymph node biopsy performed for endometrial carcinoma: is there clinical significance?

“…Thus SLNs appear to more frequently harbor unrecognized ITCs than previously recognized by published methods, which again raises the possibility that ITC detection may not impact clinical outcome. In addition, reported 5 year recurrence rate for patients with low grade, low stage endometrioid carcinoma treated with surgery alone and no adjuvant therapy is 2.6–3.1%,25 which is much less than the ITC detection rate, further supporting the proposal that ITCs may not be clinically relevant. For this reason, and the fact that in our study immunohistochemistry did not detect any additional micro- or macrometastases, this suggests that immunohistochemical evaluation of SLNs in endometrial carcinoma may not be necessary.…”

The role of nesfatin and selected molecular factors in various types of endometrial cancer

“…Among all 146 patients, a high expression of NESF-1 correlated with a high expression of MLH1 (p = 0.039), which seems to be slightly controversial. In the literature, a high expression of NESF-1 was linked to poorer prognosis, while MLH1, associated with type I EC, was linked to better prognosis [2,23,24]. Dividing the patients according to the histological type of the tumor, a tendency was noted for a high expression of NESF-1 in patients with a high expression of MSH2 (p = 0.0596).…”

Genomic Profiling of Uterine Aspirates and cfDNA as an Integrative Liquid Biopsy Strategy in Endometrial Cancer

“…Although the prognosis of EC is generally good, many cases are diagnosed at advanced stages; these cases are usually high-grade carcinomas that are ultimately more likely to recur and are associated with high mortality. In addition, a non-negligible 2.5%-3% of low-risk patients with EC have recurrent disease [2]. Overall, the prognosis for recurrent endometrial cancer is poor, especially for the 50% of advanced ECs with extra-pelvic disease recurrence [3].…”