Malignant peritoneal cytology and increased mortality risk in stage I non-endometrioid endometrial cancer

Matsuo, Koji; Nusbaum, David J.; Matsuzaki, Shinya; Chang, Erica J.; Roman, Lynda D.; Wright, Jason D.; Harter, Philipp; Klar, Maximilian

doi:10.1016/j.ygyno.2020.07.010

Cited by 27 publications

(23 citation statements)

References 39 publications

(53 reference statements)

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“…It was previously reported that compared with the small-size group, the large-size group was more tend to lymph node metastasis, distant metastasis and aggressive growth characterized, all of which were related with a poor prognosis [ 28 , 29 ]. According to the current staging system (2009 FIGO), malignant peritoneal cytology is not included as a basis of staging factors, while malignant peritoneal cytology has been reported to be strongly related with an increased risk of all-cause mortality of ECS patients [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram to predict overall survival based on the log odds of positive lymph nodes for patients with endometrial carcinosarcoma after surgery

et al. 2021

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Purpose Aims to compare the prognostic performance of the number of positive lymph nodes (PLNN), lymph node ratio (LNR) and log odds of metastatic lymph nodes (LODDS) and establish a prognostic nomogram to predict overall survival (OS) rate for patients with endometrial carcinosarcoma (ECS). Methods Patients were retrospectively obtained from Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. The prognostic value of PLNN, LNR and LODDS were assessed. A prediction model for OS was established based on univariate and multivariate analysis of clinical and demographic characteristics of ECS patients. The clinical practical usefulness of the prediction model was valued by decision curve analysis (DCA) through quantifying its net benefits. Results The OS prediction accuracy of LODDS for ECS is better than that of PLNN and LNR. Five factors, age, tumor size, 2009 FIGO, LODDS and peritoneal cytology, were independent prognostic factors of OS. The C-index of the nomogram was 0.743 in the training cohort. The AUCs were 0.740, 0.682 and 0.660 for predicting 1-, 3- and 5-year OS, respectively. The calibration plots and DCA showed good clinical applicability of the nomogram, which is better than 2009 FIGO staging system. These results were verified in the validation cohort. A risk classification system was built that could classify ECS patients into three risk groups. The Kaplan-Meier curves showed that OS in the different groups was accurately differentiated by the risk classification system and performed much better than FIGO 2009. Conclusion Our results indicated that LODDS was an independent prognostic indicator for ECS patients, with better predictive efficiency than PLNN and LNR. A novel prognostic nomogram for predicting the OS rate of ECS patients was established based on the population in the SEER database. Our nomogram based on LODDS has a more accurate and convenient value for predicting the OS of ECS patients than the FIGO staging system alone.

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Section: Discussionmentioning

confidence: 99%

Nomogram to predict overall survival based on the log odds of positive lymph nodes for patients with endometrial carcinosarcoma after surgery

et al. 2021

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“…The incidence of malignant peritoneal cytology in stage I EC has been reported from 5.3-10.5% in prior studies, and it is higher in non-endometrioid EC. [10][11][12] A retrospective observational study using the Surveillance, Epidemiology and End Results (SEER) database reported a 9.2% incidence of malignant peritoneal cytology in non-endometrioid EC and 10.7% in USC/UCCC. 11 We found a similar incidence of 10.9% in USC/UCCC.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Peritoneal Cytology in Stage I Serous and Clear Cell Carcinoma of the Endometrium

Yang

Xiang

Cao

et al. 2022

Preprint

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OBJECTIVE: To investigate the relation of malignant peritoneal cytology and survival outcomes in patients who underwent primary staging surgery for stage I uterine serous (USC) or clear cell carcinoma (UCCC). METHODS: In this retrospective analysis, patients with stage I USC or UCCC who underwent staging surgery between 2010 - 2020 from the Peking Union Medical College Hospital were identified and reviewed.RESULTS: A total of 101 patients were included and 11 patients had malignant cytology (10.9%). None of the covariates were associated with an increased likelihood of malignant peritoneal cytology. The median follow-up time was 44 months (range 6-120). A total of 11 (10.9%) patients developed recurrence: 6 (54.4%) in the malignant cytology group and 5 (5.6%) in the comparative group. Patients with malignant cytology had a higher likelihood of peritoneal recurrence and shorter time to relapse (13 vs 38 months, p=0.022), as compared to patients with negative cytology. In univariate analysis, malignant cytology and serous histology had worse progression free survival (PFS) and overall survival (OS) (all, p < 0.05). Advanced age (>60 years old), higher stage (IB), and no omentectomy were additionally associated with inferior OS (all, p < 0.05). In sensitive analysis, the detrimental effects of malignant cytology on survival were more prominent in patients over 60 years old, those with serous histology, stage IB disease, and those who received hysteroscopy as a diagnostic test. CONCLUSION: Stage I USC or UCCC patients with malignant peritoneal cytology had higher recurrence and inferior survival.

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“…Specific histologic subtypes were examined for nonendometrioid tumors (serous, clear cell, carcinosarcoma, undifferentiated, and mixed) as previously defined. 22,29 In addition, we examined the performance of surgical nodal assessment in conjunction with the cases without surgical nodal evaluation, examined as no evaluation, lymphadenectomy, and sentinel lymph node biopsy. This analysis was carried out in the whole cohort of T1 disease with any histology, nonendometrioid histology, and in low-risk endometrial cancer (well and moderately differentiated endometrioid histology, no myometrial tumor invasion beyond 50%, and tumor size of 2 cm or smaller).…”

Section: Methodsmentioning

confidence: 99%

Utilization and Outcomes of Sentinel Lymph Node Biopsy for Early Endometrial Cancer

Matsuo

Klar

Nusbaum

et al. 2022

Obstetrics &Amp; Gynecology

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Malignant peritoneal cytology and increased mortality risk in stage I non-endometrioid endometrial cancer

Cited by 27 publications

References 39 publications

Nomogram to predict overall survival based on the log odds of positive lymph nodes for patients with endometrial carcinosarcoma after surgery

Nomogram to predict overall survival based on the log odds of positive lymph nodes for patients with endometrial carcinosarcoma after surgery

Prognostic Value of Peritoneal Cytology in Stage I Serous and Clear Cell Carcinoma of the Endometrium

Utilization and Outcomes of Sentinel Lymph Node Biopsy for Early Endometrial Cancer

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