High risk endometrial cancer: Clues towards a revision of the therapeutic paradigm

Bendifallah, Sofiane; Ilenko, Anna; Daraı̈, Émile

doi:10.1016/j.jogoh.2019.06.003

Cited by 10 publications

(7 citation statements)

References 79 publications

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“…Our findings showed that white patients were more likely to develop EC, accounting for over 70% of the total. Research has found that histological type is an independent risk factor affecting prognosis [ 18 ]. As previously reported, adenocarcinoma is the predominant histological type of early onset EC [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer

Zhang,

Li,

Zhang

et al. 2023

BMC Cancer

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Background This study aimed to investigate the differences in the clinicopathological characteristics of younger and older patients with endometrial cancer (EC) and develop a nomogram to assess the prognosis of early onset EC in terms of overall survival. Methods Patients diagnosed with EC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 were selected. Clinicopathological characteristics were compared between younger and older patients, and survival analysis was performed for both groups. Prognostic factors affecting overall survival in young patients with EC were identified using Cox regression. A nomogram was created and internal validation was performed using the consistency index, decision curve analysis, receiver operating characteristic curves, and calibration curves. External validation used data from 70 patients with early onset EC. Finally, Kaplan-Meier curves were plotted to compare survival outcomes across the risk subgroups. Results A total of 1042 young patients and 12,991 older patients were included in this study. Younger patients were divided into training (732) and validation (310) cohorts in a 7:3 ratio. Cox regression analysis identified age, tumorsize, grade, FIGO stage(International Federation of Gynecology and Obstetrics) and surgery as independent risk factors for overall survival, and a nomogram was constructed based on these factors. Internal and external validations demonstrated the good predictive power of the nomogram. In particular, the C-index for the overall survival nomogram was 0.832 [95% confidence interval (0.797–0.844)] in the training cohort and 0.839 (0.810–0.868) in the internal validation cohort. The differences in the Kaplan-Meier curves between the different risk subgroups were statistically significant. Conclusions In this study, a nomogram for predicting overall survival of patients with early onset endometrial cancer based on the SEER database was developed to help assess the prognosis of patients and guide clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer

Zhang,

Li,

Zhang

et al. 2023

BMC Cancer

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“…Bendifallah et al [17] se sont intéressés à l’implication de la stadification ganglionnaire pour les carcinomes à haut risque. Cette étude retrouvait, selon les recommandations des différentes sociétés savantes internationales, une disparité sur les indications et sur les limites anatomiques de la stadification ganglionnaire.…”

Section: Discussionunclassified

Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

et al. 2020

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Introduction Les carcinomes de l’endomètre de type 2 sont des cancers peu fréquents et de mauvais pronostique. Il existe très peu d’étude analysant leur prise en charge. L’objectif de l’étude était d’étudier la prise en charge des carcinomes de type 2 dans nos centres en évaluant l’application des recommandations. Matériel et méthode Il s’agit d’une étude multicentrique rétrospective enregistrant les cancers de l’endomètre de type 2 pris en charge de janvier 2009 à décembre 2019. Les analyses ont été adaptées aux dernières recommandations françaises appliquées par rapport à l’année de prise en charge. Résultats Soixante-quatorze carcinomes de type 2 ont été analysés dans dix centres: 34 carcinosarcomes (45,9 %), 29 carcinomes séreux (39,2 %), neuf carcinomes à cellules claires (12,2 %) et deux carcinomes indifférenciés (2,7 %). Lors de la prise en charge initiale, les recommandations étaient appliquées dans 45,9 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une stadification ganglionnaire chirurgicale pour 20 patientes (57,1 %). Lors de la prise en charge adjuvante, les recommandations étaient appliquées dans 37,8 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une restadification ganglionnaire chirurgicale ou radiologique pour 25 patientes (67,6 %). Discussion L’applicabilité des recommandations pour la prise en charge des carcinomes de type 2 reste difficile en raison de l’âge élevé et des comorbidités des patientes notamment pour la réalisation d’une stadification chirurgicale ganglionnaire pelvienne et lombo-aortique. L’utilisation de nouvelles techniques de stadification permettrait de mieux sélectionner les indications de curages ganglionnaires.

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“…High-risk endometrial cancer is more aggressive [2] and has a higher rate of regional and distant metastasis than local recurrence [3,4] . For this reason, multimodal adjuvant therapy has been explored [5] . The role of adjuvant external beam radiotherapy in patients with high-risk endometrial cancer has been established, demonstrating a decrease in regional relapse [6] .…”

Section: Introductionmentioning

confidence: 99%

Impact of timing of adjuvant radiotherapy on locoregional control in patients with high-risk endometrial cancer

Díaz-cazáres¹

2023

J Cancer Metastasis Treat

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Aim: High-risk endometrial cancer has a higher risk of regional and distant recurrence. We sought to examine our institutional experience regarding the timing of adjuvant radiotherapy and local failure (LF), locoregional failure (LRF), distant failure (DF), and overall survival (OS). Methods: We retrospectively reviewed a database of patients with high-risk endometrial cancer treated with sequential chemotherapy followed by adjuvant external beam radiation therapy (EBRT) with or without brachytherapy from 2012 to 2019. Results: One hundred thirty-one patients were identified. The median age at diagnosis was 65 (range 32-81). The most prevalent FIGO stages were IIIB (28.2%, n = 37), IIIC1 (19.8%, n = 26), and IIIA (17.6%, n = 23). Of the patients, 29% (n = 38) had positive lymph nodes and 71% (n = 93) had negative lymph nodes. The most prevalent histology was endometrioid (71%, n = 93), serous (12.2%, n = 16), clear cell (9.2%, n = 12), and other (7.6%, n = 10). Moreover, 100% (n = 131) of the patients completed EBRT. The mean EBRT dose was 49.6 Gy (range 45-50.4). The median number of days between surgery and EBRT was 212.4 days (range 103-219). The mean brachytherapy dose was 14.7 Gy (range 12-30). The cumulative incidence of LF was 6.1%, LRF was 19%, DF was 19%, and the median survival was 33.4 months. For patients who completed EBRT 180 days after surgery, LRF (HR 3.55 [1.23-10.2], P = 0.013), LF (HR 1.91 [0.4-8.9], P = 0.429), DF (HR 0.91 [0.41-2], P = 0.806), and OS (HR 0.92 [0.33-2.6], P = 0.87). Conclusion: In our cohort of patients with high-risk endometrial cancer treated with chemotherapy followed by radiotherapy, delaying RT was associated with an increased risk of LRF but no differences in DF or OS.

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High risk endometrial cancer: Clues towards a revision of the therapeutic paradigm

Cited by 10 publications

References 79 publications

Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer

Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer

Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

Impact of timing of adjuvant radiotherapy on locoregional control in patients with high-risk endometrial cancer

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