Correlation of tumor size with other prognostic factors in uterine serous carcinoma: A large multi-institutional study

Winer, Ira; Mahdi, Haider; Bandyopadhyay, Sudeshna; Semaan, Assaad; Vijver, Koen K. Van de; Nucci, Marisa R.; Abdul‐Karim, Fadi W.; Hussein, Youssef; Qureshi, Faisal; Hayek, Kinda; Alosh, Baraa; Schulz, D.; Coté, Michele L.; Munkarah, Adnan; Morris, R.; Oliva, Esther; Ali-Fehmi, Rouba

doi:10.1016/j.ygyno.2012.10.027

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…From our ROC curves, a maximum sensitivity of 62.8% and specificity of 81.0% was found at a cutoff tumor size of 4.25 cm, suggesting that tumor size can reliably predict the postoperative outcomes in HCC patients. As Winer et al and Kornprat et al have shown the positive associations between tumor size and histologic type, tumor invasion, and lymph node metastasis, we also found that tumor size was significantly correlated with the HCC prognosis according to univariate analysis, suggesting that a cutoff tumor size of 4.25 cm might be a prognostic factor in HCC patients [18,19].…”

Section: Discussionsupporting

confidence: 82%

Tumor Existence and Tumor Size as Prognostic Factors in Hepatitis B Virus–Related Cirrhosis Patients Who Underwent Liver Transplantation

Wan

et al. 2014

Transplantation Proceedings

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Section: Discussionsupporting

confidence: 82%

Tumor Existence and Tumor Size as Prognostic Factors in Hepatitis B Virus–Related Cirrhosis Patients Who Underwent Liver Transplantation

Wan

et al. 2014

Transplantation Proceedings

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“…It was acknowledged that large Ts is associated with lymph node involvement and poor survival outcomes. (7,14,26) However, the risk of mortality decreased rapidly with Ts when the Ts was less than 3.5 cm, indicating that smaller Ts predicted a worse prognosis within this range of Ts in EC patients with LNM. Until now, few studies have examined the effects of small tumors on poor survival in EC.…”

Section: Discussionmentioning

confidence: 99%

Association of Tumor Size With Prognosis in Patients With Resectable Endometrial Cancer: A SEER Database Analysis

et al. 2022

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This study aimed to explore the relationship between tumor size (Ts) and prognosis in endometrial cancer (EC). A total of 52,208 patients with EC who underwent total hysterectomy were selected from the Surveillance, Epidemiology, and End Results Program database. Overall survival (OS) and endometrial cancer-specific survival (ESS) were chosen as survival outcomes. The Cox proportional hazards model was used to explore the effect of Ts on prognosis. The restricted cubic splines based on the Cox regression model were used to determine the nonlinear relationship between Ts and survival. When Ts was analyzed as a categorical variable, the risk of death increased with Ts, with the highest risk in patients with Ts > 9 cm with regard to all-cause death (ACD) (hazard ratio [HR] 1.317; 95% confidence interval [CI], 1.196-1.450; P < 0.001) and endometrial cancer-specific death (ESD) (HR, 1.378; 95% CI, 1.226-1.549; P < 0.001). As a continuous variable, Ts showed a nonlinear relationship with ACD (HR, 1.061; 95% CI, 1.053-1.069; P < 0.001) and ESD (HR, 1.062; 95% CI, 1.052-1.073; P < 0.001). The risk of mortality increased quickly with Ts when Ts was less than 7.5 cm and then leveled off when Ts was larger than 7.5 cm in all patients. Among patients with lymph node metastasis, the risk of poor prognosis decreased rapidly with Ts when Ts was less than 3.5 cm, and subsequently increased sharply with Ts when Ts ranged from 3.5 cm to 7.5 cm, and then increased slowly when Ts was larger than 7.5 cm (P < 0.001 for nonlinearity). There was a nonlinear relationship between Ts and prognosis in patients with EC. Clinicians should not ignore the impact of small tumors on prognosis in EC patients with lymph node metastasis.

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“…16 Seward et al 17 evaluated the prognostic ability of the revised 2009 staging system compared to the 1988 system in uterine serous carcinoma and concluded that the 2009 criteria did not adequately delineate survival for uterine serous carcinoma in early-stage disease. The patients with no myometrial invasion had the most favorable prognosis, which the authors argued warranted a separate substage.…”

Section: Discussionmentioning

confidence: 99%

Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment

Barlin¹,

Soslow

Lutz³

et al. 2013

Int J Gynecol Cancer

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Objective We propose a new staging system for stage I endometrial cancer and compare its performance to the 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) systems. Methods We analyzed patients with 1988 FIGO stage I endometrial cancer from January 1993 to August 2011. Low-grade carcinoma consisted of endometrioid grade 1 to grade 2 lesions. High-grade carcinoma consisted of endometrioid grade 3 or nonendometrioid carcinomas (serous, clear cell, and carcinosarcoma). The proposed system is as follows: Low-grade carcinoma with less than half myometrial invasion Negative nodes No nodes removed High-grade carcinoma with no myometrial invasion Negative nodes No nodes removed Low-grade carcinoma with half or greater myometrial invasion Negative nodes No nodes removed High-grade carcinoma with any myometrial invasion Negative nodes No nodes removed Results Data from 1843 patients were analyzed. When patients were restaged with our proposed system, the 5-year overall survival significantly differed (P < 0.001): IA1, 96.7%; IA2, 92.2%; IB1, 92.2%; IB2, 76.4%; IC1, 83.9%; IC2, 78.6%; ID1, 81.1%; and ID2, 68.8%. The bootstrap-corrected concordance probability estimate for the proposed system was 0.627 (95% confidence interval, 0.590–0.664) and was superior to the concordance probability estimate of 0.530 (95% confidence interval, 0.516–0.544) for the 2009 FIGO system. Conclusions By incorporating histological subtype, grade, myometrial invasion, and whether lymph nodes were removed, our proposed system for stage I endometrial cancer has a superior predictive ability over the 2009 FIGO staging system and provides a novel binary grading system (low-grade including endometrioid grade 1–2 lesions; high-grade carcinoma consisting of endometrioid grade 3 carcinomas and nonendometrioid carcinomas).

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Correlation of tumor size with other prognostic factors in uterine serous carcinoma: A large multi-institutional study

Cited by 7 publications

References 36 publications

Tumor Existence and Tumor Size as Prognostic Factors in Hepatitis B Virus–Related Cirrhosis Patients Who Underwent Liver Transplantation

Tumor Existence and Tumor Size as Prognostic Factors in Hepatitis B Virus–Related Cirrhosis Patients Who Underwent Liver Transplantation

Association of Tumor Size With Prognosis in Patients With Resectable Endometrial Cancer: A SEER Database Analysis

Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment

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