Histologic grade and peritoneal cytology as prognostic factors in type 1 endometrial cancer

Tanaka, Kei; Kobayashi, Yoichi; Sugiyama, Juri; Yamazaki, Tatsuo; Dozono, Kei; Watanabe, Momoe; Shibuya, Hiromi; Nishigaya, Yoshiko; Momomura, Mai; Matsumoto, Hironori; Umezawa, Sumio; Takamatsu, Kiyoshi; Iwashita, Mitsutoshi

doi:10.1007/s10147-016-1079-5

Cited by 21 publications

(13 citation statements)

References 29 publications

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“…The majority of newly diagnosed patients have a favorable prognosis with a 5-year survival rate of 81.8%, but patients with recurrent/metastatic disease have poor survival, with a 5-year survival rate of 55 and 42% after radiotherapy and chemotherapy, respectively (1,2). Clinical stage (7), histological subtype (8), grade (9), depth of invasive disease (10) and positive lymph node (11) have been reported as important prognostic factors. Elevated serum cancer antigen 125 level is observed during recurrence and tumor relapse (12).…”

Section: Introductionmentioning

confidence: 99%

Decreased secretoglobin family 2A member 1expression is associated with poor outcomes in endometrial cancer

Zhou

Zou

et al. 2020

Oncol Lett

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Endometrial cancer is the most common malignancies in developed countries. The present study aimed to identify the role of secretoglobin family 2A member 1 (SCGB2A1) expression in uteri corpus endometrial carcinoma (UCEC) from The Cancer Genome Atlas (TCGA) database, and determine the SCGB2A1-associated downstream signaling pathways. The clinicopathological characteristics and gene expression data were downloaded from TCGA database. The Kaplan-Meier method and Cox multivariate model were used for survival analysis. Logistic regression was used to analyze the association between the clinicopathological features and SCGB2A1 expression. For validation, data of SCGB2A1 mRNA expression and protein expression were obtained and then survival analysis was performed for 47 patients with endometrial cancer from the Fudan University Shanghai Cancer Center (FUSCC). In TCGA dataset, SCGB2A1 expression was significantly higher in tumor tissues (n=528) compared with normal tissues (n=23, P<0.001). The decrease in SCGB2A1 expression in UCEC was significantly associated with age at diagnosis, high tumor grade, residual tumor, positive peritoneal cytology, pelvic lymph node metastasis, para-aortic lymph node metastasis and advanced clinical stage with P<0.05. In the multivariate analysis, SCGB2A1 expression was identified as an independent prognostic factor. In the FUSCC validation set, low SCGB2A1 expression was also associated with worse survival compared with high expression in endometrial cancer (P<0.001). Gene Set Enrichment Analysis revealed that SCGB2A1 may be involved in tumor proliferation and cell cycle regulation. In conclusion, SCGB2A1 may have an important role in the prognosis of UCEC, and has value as a new target for novel therapeutic strategies.

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Section: Introductionmentioning

confidence: 99%

Decreased secretoglobin family 2A member 1expression is associated with poor outcomes in endometrial cancer

Zhou

Zou

et al. 2020

Oncol Lett

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“…24 Moreover, Tanaka et al have specifically analyzed 168 cases of endometrioid-type EC, and shown that the positive peritoneal cytology is an independent risk factor for OS and DFS. 17 In 2018, a multicenter retrospective study consisting of 1688 cases has shown that the positive peritoneal cytology is a high-risk factor for relapse, and the risk of recurrence in patients with positive peritoneal cytology is 3.07 times higher compared with the patients with negative peritoneal cytology. The author has recommended that peritoneal washing should be routinely performed.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…4 Although a limited number of articles have suggested that positive cytology is not an independent risk factor for adverse outcomes, [5][6][7][8][9][10] recent studies have repeatedly emphasized that positive peritoneal cytology is still associated with poor prognosis, even when other confounding factors are adjusted. [11][12][13][14][15][16][17][18][19][20] The prognostic value of peritoneal cytology in EC patients remains controversial. Therefore, we aimed to clarify whether positive peritoneal cytology was an independent risk factor in EC patients through a retrospective study in EC patients.…”

Section: Introductionmentioning

confidence: 99%

Positive peritoneal cytology is an independent risk factor in endometrial cancer

Dong

Wang

2020

J of Obstet and Gynaecol

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Objective We aimed to investigate whether positive peritoneal cytology could serve as a prognostic factor in endometrial cancer (EC). Methods From patients with EC surgically treated at Peking University People's Hospital between 2006 and 2016, 520 patients were selected for retrospective investigation. Clinical and pathologic factors associated with positive peritoneal cytology were assessed using univariate and multivariate logistic regressions model. Disease‐free survival (DFS) and overall survival (OS) were evaluated using Kaplan–Meier estimation and multivariate Cox regressions model. Results (i) The incidence of positive peritoneal cytology in EC patients was 9.0% (47/520). (ii) Multivariate analysis showed that the independent risk factors of positive peritoneal cytology were nonendometrioid carcinoma (odds ratio [OR] = 4.0, 95% confidence interval [CI], 1.8–8.8, P = 0.001), tumor diameter ≥2 cm (OR = 3.2, 95% CI, 1.2–8.7, P = 0.023), cervical stromal invasion (OR = 2.9, 95% CI, 1.3–6.6, P = 0.009) and distant metastasis (OR = 6.5, 95% CI, 1.7–25.4, P = 0.007). (iii) The 5‐year DFS and 5‐year OS of the positive peritoneal cytology group were significantly lower compared with the negative group (54.0% vs 93.2%, P < 0.001; 63.6% vs 94.6%, P < 0.001). (iv) After other contributing factors were adjusted in the multivariable model, positive peritoneal cytology remained an independent predictor of decreased DFS (OR = 2.8, 95% CI, 1.3–6.0, P = 0.007) and OS (OR = 2.8, 95% CI, 1.0–7.2, P = 0.035). Conclusion Positive peritoneal cytology was an independent risk factor in EC patients. Even though it is no longer an indicator according to the current International Federation of Gynecology and Obstetrics staging system, the peritoneal cytology status should still be considered for accurate risk stratification in EC.

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“…Given that peritoneal cytology is not a part of surgical staging, the relationship between survival and peritoneal cytology particularly is still very controversial in early-stage patients. While some studies showed positive peritoneal cytology is related to high rates of recurrences and poor survival ( 7 , 10 , 11 ), some found out no relationship between positive peritoneal cytology and survival ( 28 , 29 ). Seagle et al ( 30 ) analyzed data from the National Cancer Database and reported that adjuvant CT provides better survival in patients who were diagnosed as an early endometrioid type of endometrial cancer patients with positive peritoneal cytology.…”

Section: Discussionmentioning

confidence: 99%

Binary grading may be more appropriate for endometrial cancer

Koyuncu

Altın

Turgay

et al. 2020

J Turkish German Gynecol Assoc

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Objective: To elucidate the survival consequences of the prognostic factors for endometrial cancer. Material and Methods: This was a retrospective study of 276 patients diagnosed with endometrial cancer who admitted for staging surgery. The extent of the surgery was determined by clinical staging and preoperative evaluation. The pathology specimens were reassessed by a gynecopathologist. Independent risk factors were revealed for the progression-free survival (PFS), overall survival (OS) and disease-specific survival (DSS) utilizing Kaplan-Meier and “Cox” proportional analysis. Results: The median follow up of the patients was 50 months. Of the 29 patients who died, 15 (5.43%) died because of endometrial cancer. Multivariate analysis revealed that independent risk factors for OS and PFS were stage (p=0.002, 0.002, respectively) and grade 3 (G3) histology (p=0.013, 0.015, respectively). Positive peritoneal cytology was an independent risk factor for OS (p=0.024), but not for PFS (p=0.050). Stage (p=0.005) was found to be the only independent risk factor for DSS. Patients with G1 and G2 histology had a similar and more favorable prognosis than patients with G3 histology. Conclusion: Advanced stage, high-grade tumor and the presence of positive peritoneal cytology were ascertained as independent prognostic factors for endometrial cancer. A binary histological grading system could be simpler and as effective as the current three grade system because grade 1 and 2 patients showed similar prognosis.

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Histologic grade and peritoneal cytology as prognostic factors in type 1 endometrial cancer

Abstract: G2 histology and positive peritoneal cytology were independent prognostic factors for DFS and OS in type 1 endometrial cancer.

Cited by 21 publications

References 29 publications

Decreased secretoglobin family 2A member 1expression is associated with poor outcomes in endometrial cancer

Decreased secretoglobin family 2A member 1expression is associated with poor outcomes in endometrial cancer

Positive peritoneal cytology is an independent risk factor in endometrial cancer

Binary grading may be more appropriate for endometrial cancer

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