Possible Risk Factors of Pulmonary Metastases in Patients With International Federation of Gynecology and Obstetrics Stage I Endometrioid-Type Endometrial Cancer

Jiang, Wei; Tao, Xiang; Huang, Feifei; Zhu, Menghan; Wang, Chao; Feng, Weiwei

doi:10.1097/igc.0000000000001002

Cited by 15 publications

(16 citation statements)

References 29 publications

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“…Some studies showed that squamous differentiation is a risk factor for endometrial cancer recurrence. 13, 21 A retrospective study of 223 patients with early-stage endometrial cancer, carried out by Misirlioglu et al , similar with our study, regarding methodological structure, showed squamous differentiation as a risk factor for recurrence in early-stage endometrial cancer. 13 The authors reported 10.31% of recurrence (23 cases), very similar to that found in our study.…”

Section: Discussionsupporting

confidence: 87%

Squamous differentiation portends poor prognosis in low and intermediate-risk endometrioid endometrial cancer

Andrade¹,

Silva

Matsushita

et al. 2019

Preprint

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29 Background: 30 Endometrial cancer presents well-defined risk factors (myometrial invasion, 31 histological subtype, tumor grade, lymphovascular space invasion (LVSI)). Some 32 low and intermediate-risk endometrioid endometrial cancer patients exhibited 33 unexpected outcomes. The aim of this study was to investigate other clinical-34 pathological factors that might influence the recurrence rates of patients diagnosed 35 with low and intermediate-risk endometrioid endometrial cancer. 36 Methods: 37 A case-control study from a cohort retrospective of 196 patients diagnosed with 38 low and intermediate-risk endometrioid endometrial cancer at a single institution 39 between 2009 and 2014 was conducted. Medical records were reviewed to 40 compare clinical (race, smoking, menopause age, body mass index) and 41 pathological (histological characteristics (endometrioid vs endometrioid with 42 squamous differentiation), tumor differentiation grade, tumor location, endocervical 43 invasion, LVSI) features of patients with recurrence (case) and without recurrence 44 (control) of disease. Three controls for each case were matched for age and 45 staging.46 Results:47 Twenty-one patients with recurrence were found (10.7%), of which 14 were stage 48 IA, and 7 were stage IB. In accordance, 63 patients without recurrence were 49 selected as controls. There were no significant differences in any clinical 50 characteristics between cases and controls. Among pathological variables, 3 51 presence of squamous differentiation (28.6% vs. 4.8%, p=0.007), tumor 52 differentiation grade 2 or 3 (57.1% vs. 30.2%, p=0.037) and presence of 53 endocervical invasion (28.6% vs. 12.7%, p=0.103) were associated with disease 54 recurrence on univariate analysis. On multivariable analysis, only squamous 55 differentiation was a significant risk factor for recurrence (p=0.031). Conclusion:57 Our data suggest that squamous differentiation may be an adverse prognostic 58 factor in patients with low and intermediate-risk endometrioid endometrial cancer, 59 that showed a 5.6-fold increased risk for recurrence. 60 Keywords: Low and intermediate-risk endometrioid endometrial carcinoma, 61 prognostic factors, squamous differentiation

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Section: Discussionsupporting

confidence: 87%

Squamous differentiation portends poor prognosis in low and intermediate-risk endometrioid endometrial cancer

Andrade¹,

Silva

Matsushita

et al. 2019

Preprint

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“…There are several patterns of metastatic spread from EC, including intra-abdominal spread and lymph node involvement; however, distant organ metastasis involving the lungs, liver, brain, or bone is considered a unique situation. [2][3][4][5] Although distant organ metastasis is a rare event in EC, it has important implications and is associated with substantially shortened survival. 6,7 Moreover, the specific site of distant metastasis can influence survival for women with EC, and it is important to understand the patterns of metastasis in newly diagnosed cases in order to more accurately predict prognosis and select an appropriate management strategy.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of distant metastatic sites in stage IV endometrial cancer: A SEER database study of 2948 women

Liu

Chi

Zhou

et al. 2020

Intl J Gynecology & Obste

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Objective To evaluate the prognosis of women with distant metastasis at the time of endometrial cancer (EC) diagnosis and identify prognostic factors according to metastatic site. Methods A retrospective cohort study of women diagnosed with EC according to the SEER database between 2010 and 2014. Univariate and multivariate Cox regression was used to identify variables associated with overall survival. Kaplan‐Meier curves were used to compare survival among different groups. Results Overall, 2948 women with stage IV EC were identified. The most common distant metastatic site was the lung. Having a distant metastatic site independently predicted overall survival. Using brain metastasis as a reference, overall survival was longer for liver (P=0.049), lung (P=0.005), and bone (P=0.019) metastasis. Relative to no distant metastasis, overall survival was shorter for women with one (P<0.001) or two or more (P<0.001) sites of distant metastasis. Overall survival was independently influenced by tumor grade, insurance status, and surgery among women with only lung metastasis. Conclusion The findings showed that the prognosis of women with stage IV EC differs by distant metastatic site, and identified several predictors of poor survival. They may help clinicians to better predict prognosis for newly diagnosed cases of EC with distant metastasis.

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“…Patients with stage IVB endometrial carcinoma and deep myometrial invasion are at increased risk for lung metastasis 2. The risk factor associated with lung metastasis in our patient was the deep myometrial invasion 3. Surgical resection followed by systemic chemotherapy is the standard of care.…”

Section: Descriptionmentioning

confidence: 72%

Endometrial Adenocarcinoma With Pulmonary Recurrence

et al. 2018

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DesCripTionWe present the case of an 83-year-old woman with a history of grade 1 stage IB endometrial cancer (endometrial adenocarcinoma) (figure 1) involving the lower uterine segment. She underwent robotic hysterectomy with right salpingo-oophorectomy followed by brachytherapy. A year and a half later, she presented with difficulty in breathing. A chest X-ray showed 8 mm nodular density in the right lower lobe. The above finding was confirmed with CT. Given the concern for a malignant lesion, positron emission tomography/CT scan was performed, which revealed two metabolically active lung nodules, measuring 1.2 cm in the right middle lobe and other in the right lower lobe measuring 1.2 cm (figure 2). Video-assisted thoracoscopic wedge resection of the right lower lobe lung nodule was performed. The frozen section and histopathology revealed papillary adenocarcinoma (figures 3 and 4); nuclear staining was positive for oestrogen receptors and negative for thyroid transcription factor-1 (figure 5). Thus, primary lung adenocarcinoma was ruled out and diagnosis of metastatic endometrial carcinoma was established. She was then started on systemic chemotherapy with carboplatin and paclitaxel. The incidence of lung metastasis in patients with endometrial cancer is 2.3-4.6%. 1Patients with stage IVB endometrial carcinoma and deep myometrial invasion are at increased risk for lung metastasis.2 The risk factor associated with lung metastasis in our patient was the deep myometrial invasion.3 Surgical resection followed by systemic chemotherapy is the standard of care. Overall survival in patients with

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Possible Risk Factors of Pulmonary Metastases in Patients With International Federation of Gynecology and Obstetrics Stage I Endometrioid-Type Endometrial Cancer

Abstract: Supplemental digital content is available in the text.

Cited by 15 publications

References 29 publications

Squamous differentiation portends poor prognosis in low and intermediate-risk endometrioid endometrial cancer

Squamous differentiation portends poor prognosis in low and intermediate-risk endometrioid endometrial cancer

Prognostic value of distant metastatic sites in stage IV endometrial cancer: A SEER database study of 2948 women

Endometrial Adenocarcinoma With Pulmonary Recurrence

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