Does the Type of Surgical Approach and the Use of Uterine Manipulators Influence the Disease-Free Survival and Recurrence Rates in Early-Stage Endometrial Cancer?

BackgroundThe purpose of this study was to establish a nomogram combining classical parameters and immunohistochemical markers to predict the recurrence of patients with stage I-II endometrial cancer (EC).Methods419 patients with stage I-II endometrial cancer who received primary surgical treatment at the First Affiliated Hospital of Chongqing Medical University were involved in this study as a training cohort. Univariate and multivariate Cox regression analysis of screening prognostic factors were performed in the training cohort to develop a nomogram model, which was further validated in 248 patients (validation cohort) from the Second Affiliated Hospital of Chongqing Medical University. The calibration curve was used for internal and external verification of the model, and the C-index was used for comparison among different models.ResultsThere were 51 recurrent cases in the training cohort while 31 cases in the validation cohort. Univariate analysis showed that age, histological type, histological grade, myometrial invasion, cervical stromal invasion, postoperative adjuvant treatment, and four immunohistochemical makers (Ki67, estrogen receptor, progesterone receptor, P53) were the related factors for recurrence of EC. Multivariate analysis demonstrated that histological type (P = 0.029), myometrial invasion (P = 0.003), cervical stromal invasion (P = 0.001), Ki67 (P < 0.001), ER (P = 0.009) and P53 expression (P = 0.041) were statistically correlated with recurrence of EC. Recurrence-free survival was better predicted by the proposed nomogram with a C-index of 0.832 (95% CI, 0.752–0.912) in the training cohort, and the validation set confirmed the finding with a C-index of 0.861 (95% CI, 0.755–0.967).ConclusionThe nomogram model combining classical parameters and immunohistochemical markers can better predict the recurrence in patients with FIGO stage I-II EC.

show abstract

“…Patients received chemotherapy or radiotherapy before surgery; 5. Patients without regular follow-up ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

A Nomogram Model Involving Immunohistochemical Markers for Predicting the Recurrence of Stage I-II Endometrial Cancer

Jiang

Jia

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The exclusion criteria were as follows: 1) The patient did not follow the standard surgical treatment; 11 2) Patients with other malignancies; 3) Patients who had received chemotherapy or radiotherapy before surgery; and 4) Patients without regular follow-ups. 12 …”

Section: Methodsmentioning

confidence: 99%

<p>Prognostic Value of Ki67 in Patients with Stage 1–2 Endometrial Cancer: Validation of the Cut-off Value of Ki67 as a Predictive Factor</p>

Jiang

Jia

et al. 2020

OTT

View full text Add to dashboard Cite

Objective The purpose of this study was to find a cut-off value of the immunohistochemical parameter Ki67 for stage I–II endometrial cancer. Materials and Methods The clinicopathological data of 318 patients with stages I–II endometrial cancer who received primary surgical treatment were retrospectively analyzed. A cut-off value of Ki67 for predicting recurrence of endometrial cancer was determined by using the receiver operating characteristic curve and the Youden index. The Cox regression was performed to screen factors associated with recurrence of endometrial cancer. Based on the cut-off value of Ki67, the patients were divided into two groups, and the differences of clinicopathological parameters between the two groups were compared. Results The receiver operating characteristic curve showed that the optimal cut-off value of Ki67 for predicting recurrence of patients with stages I–II endometrial cancer was 38%. The multivariate Cox regression analysis demonstrated that the histotypes ( P =0.012), myometrial invasion ( P =0.014), cervical stromal invasion ( P =0.001), Ki67 ( P =0.002), estrogen receptor (ER) ( P =0.045) and P53 ( P =0.032) were significant prognostic predictors for recurrence of endometrial cancer. The recurrence-free survival and the disease-specific survival of patients in the high-Ki67 group (Ki67 ≥38%) were much lower than those in the low-Ki67 group (Ki67 <38%) ( P =0.000, P =0.001, respectively). Among the 118 patients with early low-risk endometrial cancer who did not receive adjuvant treatment after surgery, the recurrence-free survival of patients in the high-Ki67 group was also lower than those in the low-Ki67 group ( P =0.000). Conclusion The Ki67 was demonstrated to be a useful prognostic factor in patients with stages I–II endometrial cancer, and the Ki67 labeling index 38.0% was optimal cut-off value for predicting recurrence.

show abstract

“…Exclusion criteria were patients not following the routine standardized surgical treatment, 4 pathological analysis indicated endometrial sarcoma, Those with other malignancies, having received chemotherapy or radiotherapy before surgery, and patients who failed to adhere to postoperative and follow-up schemes. 10 …”

Section: Methodsmentioning

confidence: 99%

<p>Predicting Recurrence in Endometrial Cancer Based on a Combination of Classical Parameters and Immunohistochemical Markers</p>

Jiang

Huang

Deng

et al. 2020

CMAR

View full text Add to dashboard Cite

The aim of this study was to establish a nomogram to predict the recurrence of endometrial cancer (EC) by immunohistochemical markers and clinicopathological parameters and to evaluate the discriminative power of this model. Methods: The data of 473 patients with stages I-III endometrial cancer who had received primary surgical treatment between October 2013 and May 2018 were randomly split into two sets: a training cohort and a validation cohort at a predefined ratio of 7:3. Univariate and multivariate Cox regression analysis of screening prognostic factors were performed in the training cohort (n=332) to develop a nomogram model for EC-recurrence prediction, which was further evaluated in the validation cohort (n=141). Results: Univariate analysis found that FIGO stage, histological type, histological grade, myometrial invasion, cervical stromal invasion, postoperative adjuvant treatment, and four immunohistochemical markers (Ki67, ER, PR, and p53) were associated with recurrence in EC. Multivariate analysis showed that FIGO stage, histological type, ER, and p53 were superior parameters to generate the nomogram model for recurrence prediction in EC. Recurrence-free survival was better predicted by the proposed nomogram, with a C-index value of 0.79 (95% CI 0.66-0.92) in the validation cohort. Conclusion: This nomogram model involving immunohistochemical markers can better predict recurrence in FIGO stages I-III EC.

show abstract

Does the Type of Surgical Approach and the Use of Uterine Manipulators Influence the Disease-Free Survival and Recurrence Rates in Early-Stage Endometrial Cancer?

Cited by 30 publications

References 21 publications

A Nomogram Model Involving Immunohistochemical Markers for Predicting the Recurrence of Stage I-II Endometrial Cancer

A Nomogram Model Involving Immunohistochemical Markers for Predicting the Recurrence of Stage I-II Endometrial Cancer

<p>Prognostic Value of Ki67 in Patients with Stage 1–2 Endometrial Cancer: Validation of the Cut-off Value of Ki67 as a Predictive Factor</p>

<p>Predicting Recurrence in Endometrial Cancer Based on a Combination of Classical Parameters and Immunohistochemical Markers</p>

Contact Info

Product

Resources

About