High-grade endometrial cancer: Revisiting the impact of tumor size and location on outcomes

Doll, Kemi M.; Tseng, Jill; Denslow, Sheri; Fader, Amanda N.; Gehrig, Paola A.

doi:10.1016/j.ygyno.2013.10.023

Cited by 48 publications

(35 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8 Moreover, in other previous reports, a shorter OS was found in patients with larger TS, particularly in those with 19 Chattopadhyay et al, 12 in 2013, described TS as an independent predictor of distant failure and shorter OS in EC patients.…”

Section: Discussionmentioning

confidence: 84%

Tumor Size, an Additional Risk Factor of Local Recurrence in Low-Risk Endometrial Cancer: A Large Multicentric Retrospective Study

Sozzi

Uccella

Berretta

et al. 2018

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 84%

Tumor Size, an Additional Risk Factor of Local Recurrence in Low-Risk Endometrial Cancer: A Large Multicentric Retrospective Study

Sozzi

Uccella

Berretta

et al. 2018

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…Even with this differential practice, lymph node positivity was comparable between the 2 cohorts (23%, 14 of 61 and 25%, 14 of 55); this was expected since most patients in both institutions with positive lymph nodes (24%, 28 of 116) presented with tumor sizes >2cm (93%, 26 of 28), which is reportedly associated with pelvic nodal disease in high-grade endometrial cancers. 30 …”

Section: Discussionmentioning

confidence: 99%

Interobserver Variability in the Diagnosis of Uterine High-Grade Endometrioid Carcinoma

Thomas¹,

Hussein²,

Bandyopadhyay³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context Low interobserver diagnostic agreement exists among high-grade endometrial carcinomas. Objective Evaluate diagnostic variability in FIGO grade 3 endometrioid adenocarcinoma (G3EC) in two different sign-out practices. Design Sixty-six G3EC cases were identified from pathology archives of Wayne State University, Detroit, MI (WSU) (general surgical pathology sign-out) and 65 from Memorial Sloan Kettering Cancer Center, New york, NY (MSK) (gynecologic pathology focused sign-out). Each case was reviewed together by two gynecologic pathologists, one from each institution, and classified into G3EC group or reclassified group. Clinicopathological parameters were compared. Results Twenty-five (38%) WSU cases were reclassified as undifferentiated (2), serous (4), mixed endometrioid and serous (12) carcinomas, and FIGO grade 2 endometrioid (G2EC) with focal marked nuclear atypia (7). Eleven (17 %) MSK cases were reclassified as undifferentiated (5), serous (1), mixed endometrioid and serous (4), mixed endometrioid and clear cell (1) carcinomas. Agreement rate between original and review diagnosis was 83% (54 of 65) at MSK and 62% (41 of 66) at WSU (P= .01) with overall rate of 73% (95 of 131). Undifferentiated carcinomas were higher at MSK than WSU (46 %, 5 of 11 vs. 8%, 2 of 25; P= .02). G2EC with focal marked nuclear atypia was higher in WSU (28%, 7 of 25) than MSK (0%) (P= .03). Mixed endometrioid and serous carcinoma was the most common misclassified subtype (44%, 16 of 36). Conclusions Moderate interobserver variability exists in the diagnosis of G3EC with significantly higher diagnostic agreement rate in gynecologic pathology focused sign-out than general sign-out practice.

show abstract

“…The location of the tumor within the uterus is also an important indicator. Involvement of the uterine isthmus, cervix, or both is associated with an increased risk for extrauterine disease and lymph node metastasis as well as recurrence [ 13 , 31 , 32 ]. In our study, patients with intermediate-risk EEC with nodal metastasis were more likely to have lesions located in the cornua (3/87, 3.4%) and were more likely to have diffuse lesions (6/126, 4.8%).…”

Section: Discussionmentioning

confidence: 99%

Whether intermediate-risk stage 1A, grade 1/2, endometrioid endometrial cancer patients with lesions larger than 2 cm warrant lymph node dissection?

et al. 2017

View full text Add to dashboard Cite

BackgroundOur research aimed to investigate whether lymphadenectomy was required in patients with intermediate-risk endometrioid endometrial cancer (EEC).MethodsBetween 1989 and 2015, 1009 patients with intermediate-risk EEC: grade 1 or 2 tumor, <50% myometrial invasion, and a tumor diameter ≥ 2 cm and 818 low-risk patients with grade 1 or 2 tumor, <50% myometrial invasion, and a tumor diameter < 2 cm were enrolled in this study. The rate and risk factors of node metastasis were evaluated and compared between the two risk groups. Survival data were analyzed in patients with intermediate-risk EEC with or without lymphadenectomy.ResultsIn all, 624 of 1009 (61.8%) patients with intermediate-risk EEC underwent pelvic ± para-aortic lymphadenectomy with a nodal metastasis rate of 1.9% (12/624), whereas 394 of 818 (48.2%) patients with low-risk EEC underwent pelvic ± para-aortic lymphadenectomy with a nodal metastasis rate of 0.3% (1/394) (p = 0.021). Notably, intermediate-risk EEC patients with a microcystic, elongated and fragmented (MELF) pattern of invasion, lymphatic vascular space invasion (LVSI), diffuse lesions, or lesions located in the cornua were more likely to have node metastasis. The 5-year overall cancer-related survival and the recurrence-free survival rates of the 742 intermediate-risk EEC patients who were followed for more than 3 years were 99.4% and 94.7%, respectively. In intermediate-risk group, 6 patients (6/443, 1.4%) with lymphadenectomy and 9 patients (9/299, 3.0%) without lymphadenectomy recurred, with a mean recurrence time of 38.3 and 18.7 months respectively. The five-year overall and recurrence-free survival rates of intermediate-risk patients with and without lymphadenectomy were similar (100% vs 98.9%, p = 0.351; 95.2% vs 93.3%, p = 0.464).ConclusionPatients with intermediate-risk EEC have low nodal metastasis rate and a favorable outcome whether lymphadenectomy is performed or not. Omission of lymphadenectomy may be a reasonable option in the surgical management of patients with intermediate-risk EEC.

show abstract

High-grade endometrial cancer: Revisiting the impact of tumor size and location on outcomes

Cited by 48 publications

References 19 publications

Tumor Size, an Additional Risk Factor of Local Recurrence in Low-Risk Endometrial Cancer: A Large Multicentric Retrospective Study

Tumor Size, an Additional Risk Factor of Local Recurrence in Low-Risk Endometrial Cancer: A Large Multicentric Retrospective Study

Interobserver Variability in the Diagnosis of Uterine High-Grade Endometrioid Carcinoma

Whether intermediate-risk stage 1A, grade 1/2, endometrioid endometrial cancer patients with lesions larger than 2 cm warrant lymph node dissection?

Contact Info

Product

Resources

About