Overall survival and disease-free survival in endometrial cancer: prognostic factors in 276 patients

Abstract

ObjectiveThe aim of the study reported here was to assess the disease-free survival and overall survival of patients with endometrial cancer and to determine independent factors affecting the prognosis.Materials and methodsThis was a retrospective study of a single-center clinical series of 276 patients (mean age 64 years) with histologically confirmed cancer of the corpus uteri. The standard treatments were extrafascial total hysterectomy and bilateral salpingo-oophorectomy with selective pelvic/para-aortic node dissection, according to risk for recurrence. Actuarial overall survival and disease-free survival were estimated according to the Kaplan–Meier method. Univariate and multivariate Cox proportional hazards analyses were used to assess the prognostic significance of the different variables.ResultsThe estimated median follow-up, determined using the inverse Kaplan–Meier method, was 45 months (95% confidence interval [CI] 41.2–48.8) for disease-free survival and 46 months (95% CI 43.0–49.0) for overall survival. The statistically significant variables affecting disease-free survival and overall survival were age, serous-papillary and clear-cell histological types, outer-half myometrial invasion, advanced International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grades G2 and G3, incomplete surgical resection, positive lymph nodes, lymphovascular space invasion, tumor remnants of >1 cm after surgery, and high-risk group. In the multivariate Cox regression model, predictors of tumor recurrence included advanced FIGO stage (hazard ratio [HR] 4.90, 95% CI 2.57–9.36, P < 0.001) and tumor grades G2 (HR 4.79, 95% CI 1.73–13.27, P = 0.003) and G3 (HR 7.56, 95% CI 2.75–20.73, P < 0.001). The same variables were also associated with a significantly higher risk of tumor-related mortality.ConclusionFIGO stage and tumor grade were independent prognostic factors of disease-free survival and overall survival in endometrial cancer patients. Outcome was also influenced by histopathologic type, myometrial and lymphovascular space invasion, lymph-node involvement, age, and tumor remnants after surgery, although a larger study sample is probably needed to demonstrate the independent association of these variables with survival.

The potential predictive value of serum srCaS1 levels for overall survival in endometrial cancer

“…However, another study by Sonoda et al [31], reported a strong and positive correlation between tumor RCAS1 immunoreactivity and patient age. Patients' age is in general regarded as a negative prognostic factor in endometrial cancer [34,35]. Our results confirm this observation, because advanced age was associated with shortened survival.…”

Median Survival Time of Endometrial Cancer Patients with Lymphovascular Invasion at the Hospital Universiti Sains Malaysia

“…However, the median survival in our study is lower than the medial survival reported in Thailand in 2010 (14) and higher than that reported in Madrid, Spain in 2013 (15). Several prognostic factors have been shown to be predictors of survival in patients with endometrial cancer.…”

Incidence of positive peritoneal cytology in patients with endometrial carcinoma after hysteroscopy vs. dilatation and curettage

“… 20 Disease-free survival has been shown to be 91% in FIGO stage I patients and 52.5% in those with FIGO stage II, III and IV. 21 In the study by Garg et al ., survival in patients with stage I endometrioid adenocarcinoma with positive peritoneal washings was significantly poorer than in patients with negative peritoneal washings (88.2% vs . 98.6%).…”