Good Outcome Associated with a Standardized Treatment Protocol Using Selective Postoperative Radiation in Patients with Clinical Stage I Adenocarcinoma of the Endometrium

Carey, Mark; O'Connell, G.; Johanson, Curtis R.; Goodyear, Michael D.; Murphy, Kelley J.; Daya, Dean; Schepansky, A.; Péloquin, A; Lumsden, Brenda J.

doi:10.1006/gyno.1995.1115

Cited by 149 publications

(67 citation statements)

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“…Early-stage endometrial carcinoma shows a good prognosis, and the 5-y survival rate is reported to be more than 90% in patients with stage Ia or Ib determined by the International Federation of Gynecology and Obstetrics (FIGO) classifications (3)(4)(5). On the other hand, patients with advanced disease have a significantly worse survival.…”

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confidence: 99%

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET

Tsujikawa¹,

Yoshida

Kudo³

et al. 2009

J Nucl Med

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The grade of histologic differentiation is one of the most important prognostic factors in patients with endometrial carcinoma and postoperative staging. The aim of this study was to investigate whether 16a-18 F-fluoro-17b-estradiol ( 18 F-FES) and 18 F-FDG PET reflect clinicopathologic features in patients with endometrial tumors. Methods: A total of 22 patients with endometrial adenocarcinoma and 9 with endometrial hyperplasia (mean age, 56.0 6 15.3 y) underwent 18 F-FES PET for estrogen receptor imaging and 18 F-FDG PET. Regional values of tracer uptake were evaluated using standardized uptake value (SUV) and the SUV ratio of 18 F-FDG to 18 F-FES. The accuracy for predicting tumor aggressiveness defined as high-risk carcinoma (International Federation of Gynecology and Obstetrics [FIGO] stage $ Ic or histologic grade $ 2), low-risk carcinoma (FIGO stage # Ib and grade 1), and hyperplasia was compared for each PET parameter using receiver-operating-characteristic (ROC) analysis. The diagnostic accuracy of MRI findings for clinical staging was also compared. Results: Although the SUV for 18 F-FDG was significantly lower in endometrial hyperplasia than in carcinoma, a significant difference between high-risk and low-risk carcinoma was observed only in SUV for 18 F-FES. High-risk carcinoma showed a significantly greater 18 F-FDG-to-18 F-FES ratio (3.6 6 2.1) than did low-risk carcinoma (1.3 6 0.5, P , 0.01) and hyperplasia (0.3 6 0.1, P , 0.005). Low-risk carcinoma showed a significantly higher 18 F-FDG-to-18 F-FES ratio than hyperplasia (P , 0.0001). In ROC analysis, the most accurate diagnostic PET parameter for predicting high-risk and low-risk carcinoma was the 18 F-FDG-to-18 F-FES ratio. The optimal 18 F-FDG/ 18 F-FES cutoff value of 2.0, determined by ROC analysis, revealed 73% sensitivity, 100% specificity, and 86% accuracy, which was better than the 77% accuracy for MRI. The 18 F-FDGto-18 F-FES ratio of 0.5 yielded a correct diagnosis for carcinoma from hyperplasia with 100% accuracy. Conclusion: Endometrial carcinoma reduces estrogen dependency with accelerated glucose metabolism as it progresses to a higher stage or grade. 18 F-FES and 18 F-FDG PET studies provide a new index of the 18 F-FDG-to-18 F-FES ratio, which is considered the most informative index reflecting tumor aggressiveness. This index will be useful for making noninvasive diagnoses and deciding the appropriate therapeutic strategy for patients with endometrial carcinoma.

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confidence: 99%

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET

Tsujikawa¹,

Yoshida

Kudo³

et al. 2009

J Nucl Med

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“…The prognostic value of the degree of differentiation and depth of myometrial invasion is well established (1)(2)(3)(4)(5). Our group has shown that a small area of solid growth in an otherwise moderately differentiated tumor (MD + S)…”

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confidence: 99%

The Prognostic Information of DNA Ploidy and S-PHASE Fraction May Vary with Histologic Grade in Endometrial Carcinoma

et al. 1995

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“…Several investigators have recommended a therapeutic advantage associated with lymphadenectomy (10)(11)(12)(13)(14), while others have shown no survival advantage (15,16). Obviously, there is still considerable controversy over the advantages and risks of lymph-node dissection in lowrisk (e.g.…”

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confidence: 99%

Association between Retroperitoneal Lymphadenectomy and Survival Benefit in the Endometrioid-Type Endometrial Carcinoma Patients

Cheraghi

Gilani

Ghaemmaghami

et al. 2015

Jentashapir J Health Res

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Background: Uterine cancer stays the most prevalent gynecologic malignancy in developed countries. Providing suitable solutions to treat this disease is required to the early diagnosis of this cancer. Objectives: The aim of this study was to evaluate the effectiveness of multiple-site lymph node sampling in patients with the endometrioid type of endometrial cancer. Patients and Methods: Demographic and clinicopathologic data were obtained from the Tehran Gynecology Oncology ward in Vali-e-Asr Hospital between 1999 and 2010. All the patients were divided into two groups. Group A (n = 102): patients who underwent multiple-site lymph node sampling; and Group B (n = 102): patients who did not undergo multiple-site lymph node sampling. Survival curves were calculated using the Kaplan-Meier method, and the differences in survival rates were analyzed using the log-rank test. Results: The median age was 55 years (range = 18 -84). The 5-year progression-free survival rates of Groups A and B were 85% and 87%, respectively (P = 0.456). In addition, the 5-year overall survival rates were 95% and 93.9%, respectively (P = 0.651). Subsequently, there was no significant difference in recurrence rates in retroperitoneal lymph nodes regardless of the completion of lymphadenectomy. Conclusions:The obtained data showed no evidence of benefit in terms of overall or recurrence-free survival for pelvic lymphadenectomy in women with early endometrial cancer.

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Good Outcome Associated with a Standardized Treatment Protocol Using Selective Postoperative Radiation in Patients with Clinical Stage I Adenocarcinoma of the Endometrium

Cited by 149 publications

References 0 publications

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET

The Prognostic Information of DNA Ploidy and S-PHASE Fraction May Vary with Histologic Grade in Endometrial Carcinoma

Association between Retroperitoneal Lymphadenectomy and Survival Benefit in the Endometrioid-Type Endometrial Carcinoma Patients

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Good Outcome Associated with a Standardized Treatment Protocol Using Selective Postoperative Radiation in Patients with Clinical Stage I Adenocarcinoma of the Endometrium

Cited by 149 publications

References 0 publications

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with 18F-FDG PET

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with 18F-FDG PET

The Prognostic Information of DNA Ploidy and S-PHASE Fraction May Vary with Histologic Grade in Endometrial Carcinoma

Association between Retroperitoneal Lymphadenectomy and Survival Benefit in the Endometrioid-Type Endometrial Carcinoma Patients

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Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET

Functional Images Reflect Aggressiveness of Endometrial Carcinoma: Estrogen Receptor Expression Combined with ¹⁸F-FDG PET