Predictors of Distant Recurrence in Clinical Stage I or II Endometrial Carcinoma Treated by Combination Surgical and Radiation Therapy

Descamps, Philippe; Calais, G.; Moire, C.; Bertrand, P; Castiel, Mercedes; Floch, O. Le; Lansac, J.; Body, G.

doi:10.1006/gyno.1996.4511

Cited by 62 publications

(47 citation statements)

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“…These results were at variance with a study by Descamps et al in which grade 3, depth of MI and lymph node involvement were found to be significant in predicting FFS. 13 In the series by Descamps et al less than 10% of patients were node positive compared to 45.3% in our series. 13 Generally speaking, patients with positive nodes have a higher rate of failure that can be prevented with adjuvant pelvic radiotherapy.…”

Section: Nodes and Figo Stagecontrasting

confidence: 57%

Prognostic significance of several histological features in intermediate and high‐risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

et al. 2009

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SummaryThe purpose of the present study was to explore the prognostic significance of several histological features with respect to lymph node metastasis, failure-free survival (FFS), and overall survival (OS) in intermediate and high-risk endometrial cancer patients treated with curative intent. One hundred and eighty patients with endometrial cancer were treated with hysterectomy with or without lymphadenectomy and received external beam radiotherapy (EBRT). The mean follow-up period was 4.25 years (range 0.44-10.45 years). In multifactor analysis, fractional myometrial invasion (MI) (P = 0.047), histology (P < 0.001) and lymph-vascular space invasion (LVSI) (P = 0.025) were significant predictors for FFS when nodal status was not included. When lymph node status was known, histology (P = 0.007) and LVSI (P = 0.014) remained significant factors for FFS. For OS, histology (P < 0.001) and fractional MI (P = 0.004) were the significant factors. Lymph node status could be predicted by tumour grading (P = 0.016) and absolute MI (P = 0.002). Histology type and the presence of LVSI were the most important prognostic factors in high-risk endometrial cancer patients treated by surgery and postoperative radiotherapy. Absolute MI and tumour grading were useful predictors of nodal spread.

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Section: Nodes and Figo Stagecontrasting

confidence: 57%

Prognostic significance of several histological features in intermediate and high‐risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

et al. 2009

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“…Based on studies that found that positive cytology is an independent adverse prognostic factor (Harouny et al, 1988;Mazurka et al, 1988;Brewington et al, 1989;Turner et al, 1989;Sutton, 1990;Morrow et al, 1991;Grigsby et al, 1992;Kadar et al, 1994;Descamps et al, 1997;Kashimura et al, 1997;Obermair et al, 2001), postoperative adjuvant therapy was recommended for patients with positive peritoneal cytology. Progestins, whole abdominal external radiation, intraperitoneal radioactive chromic phosphate ( 32 P), and multiagent chemotherapy have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus

et al. 2003

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A retrospective analysis was performed to evaluate the prognostic significance of peritoneal cytology in patients with endometrial carcinoma limited to the uterus. A total of 280 patients with surgically staged endometrial carcinoma that was histologically confined to the uterus were examined clinicopathologically. The median length of follow-up was 62 (range, 12 -135) months. All patients underwent hysterectomy and salpingo-oophorectomy with selective lymphadenectomy, and only three patients received adjuvant postoperative therapy. No preoperative adjuvant therapy was employed. In all, 48 patients (17%) had positive peritoneal cytology. The 5-year survival rate among patients with positive or negative peritoneal cytology was 91 or 95%, respectively, showing no significant difference (log-rank, P ¼ 0.42). The disease-free survival rate at 36 months was 90% among patients with positive cytology, compared with that of 94% among patients with negative cytology, and the difference was not significant (log-rank, P ¼ 0.52). Multivariate proportional hazards model revealed only histologic grade to be an independent prognostic factor of survival (P ¼ 0.0003, 95% CI 3.02 -40.27) among the factors analysed (age, peritoneal cytology, and depth of myometrial invasion). Multivariate analysis revealed that histologic grade (P ¼ 0.02, 95% CI 1.21 -9.92) was also the only independent prognostic factor of disease-free survival. We concluded that the presence of positive peritoneal cytology is not an independent prognostic factor in patients with endometrial carcinoma confined to the uterus, and adjuvant therapy does not appear to be beneficial in these patients.

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“…This recurrence rate compares favorably with the rates published in other studies, ranging from 4 to 19% in early-stage patients. 3,9,16 In our study, cervical involvement was the most relevant independent prognostic factor in endometrial cancer that was histologically confined to the uterus. The fact that we found only this factor as an independent prognostic factor in the women with stage I and II high-risk endometrial cancer may be due to the relatively small number of patients with recurrent disease, limiting the statistical power.…”

Section: Early Stage Endometrial Carcinoma and Adjuvant Therapy: Detementioning

confidence: 48%

“…The overall survival rate is 76-85% for Stage I and 46-85% for stage II. 3,5,8,9 It is generally accepted that patients with FIGO stage IA and IB, grade 1 or 2 tumors, do not require additional therapy. However, given the presence of variable prognostic factors, recurrences occur and the survival rate for relapsed patients is poor.…”

Section: Early Stage Endometrial Carcinoma and Adjuvant Therapy: Detementioning

confidence: 99%

“…However, given the presence of variable prognostic factors, recurrences occur and the survival rate for relapsed patients is poor. [9][10][11] Therefore, the decision to provide adjuvant treatment depends on the presence of certain risk factors. 12 These treatments include radiotherapy, chemotherapy and hormonal therapy.…”

Section: Early Stage Endometrial Carcinoma and Adjuvant Therapy: Detementioning

confidence: 99%

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Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases

et al. 2008

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Objective:We assessed the prognostic factors and the efficacy of adjuvant therapy and reviewed randomized studies carried out on patients receiving adjuvant therapy with early endometrial carcinoma. Methods: One hundred and five patients that received primary surgical treatment for stage IB, IC and II endometrial cancer were enrolled in this study. The clinical outcomes were compared among the patients with variable prognostic factors and adjuvant treatments. Results: One hundred and five patients fulfilled the eligibility criteria and 46 patients (43.8%) underwent adjuvant therapy. Disease recurrence occurred in nine patients within a median time of 24 months. Cervical involvement was an independent prognostic factor for the disease-free survival rates. Eight of 16 patients with FIGO stage II disease received adjuvant chemotherapy consisting of cisplatin and etoposide (or cyclophosphamide) or combined chemoradiation. The 5-year disease-free survival rate for these patients was 87.5%, a value significantly higher than for patients that received radiation therapy alone (30%). Conclusion: Adjuvant chemotherapy or combination chemo-radiotherapy might be superior to radiation therapy alone in high-risk early endometrial cancer patients.

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Predictors of Distant Recurrence in Clinical Stage I or II Endometrial Carcinoma Treated by Combination Surgical and Radiation Therapy

Cited by 62 publications

References 0 publications

Prognostic significance of several histological features in intermediate and high‐risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

Prognostic significance of several histological features in intermediate and high‐risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus

Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases

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