The effect of myometrial invasion on prognostic factors and survival analysis in endometrial carcinoma

Dane, Cem; Bakir, Sait

doi:10.4314/ahs.v19i4.47

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…Another important parameter that effects lymph node metastasis rate and prognosis is myometrial invasion depth. 16 Cirisano et al found lymph node metastasis in 11 cases out of 36 Grade 3 endometrioid carcinoma with tumor invasion more than half of the myometrium while only 1 of 21 cases with less than half myometrial invasion showed lymph node metastasis. 17 In a study by Li et al, it was shown that the risk of metastasis to the pelvic lymph nodes was significantly increased in patients with non-endometrioid type tumor or Grade 3 tumor or with myometrial invasion of more than half.…”

Section: Discussionmentioning

confidence: 97%

Correlation Between Frozen Section and Definitive Diagnosis in High-Risk Endometrial Carcinoma: Retrospective Analysis

Özşen¹,

Yirmibeş²,

Atalay³

2022

J Clin Obstet Gynecol

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Intraoperative evaluation has a significant role in identification, management, and treatment planning of gynecological malignancies. A majority of gynecological intraoperative evaluations consist of ovarian and endometrial cancers. Although preoperative biopsy is performed for endometrial tumors, biopsy or curettage materials are limited in terms of histopathological subtyping, grading, depth of invasion, extent of tumor and the status of lymph nodes. This makes intraoperative diagnosis important and necessary for endometrial cancers, which require a multidisciplinary approach in treatment strategies. 1,2 Intraoperative surgical staging and determining an early treatment plan is an opportunity enabled by frozen evaluation in high-risk endometrial cancers and is effective in determining the prognosis. 3 This study aims to evaluate the correlation of intraoperative and definitive diagnosis in high-risk endometrial carcinomas, and percentages of compliance or non-compliance of frozen examination in high-risk endometrial carcinoma cases. MATERIAL AND METHODSThe study included 90 high-risk endometrial carcinoma cases which were evaluated intraoperatively in our center, between 2005 and 2017. The following criteria were used to identify high-risk endometrial carcinoma cases: Grade 3 endometrioid carcinomas with lymphovascular invasion and/or myometrial invasion of more than half, tumors of Stage 2, 3, 4 and non-endometrioid endometrial carcinoma. Cases with

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Section: Discussionmentioning

confidence: 97%

Correlation Between Frozen Section and Definitive Diagnosis in High-Risk Endometrial Carcinoma: Retrospective Analysis

Özşen¹,

Yirmibeş²,

Atalay³

2022

J Clin Obstet Gynecol

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“…In addition, European Society for Medical Oncology (ESMO) reported that DMI can be used as a criterion for classification of patients of different risk groups. Dane et al (16) explored the relationship between myometrial invasion and progression-free survival (PFS) or overall survival (OS) in EC. Their findings showed that patients with DMI exhibited a shorter PFS and OS, implying that DMI is an important prognostic indicator and can be used as a determinant of treatment in EC.…”

Section: Discussionmentioning

confidence: 99%

Preoperative MRI and immunohistochemical examination for the prediction of high-risk endometrial cancer

Chen

Fan

et al. 2021

Gland Surg

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Background: Magnetic resonance imaging (MRI) and immunohistochemical (IHC) examination provides useful information for the risk stratification of endometrial cancer (EC). However, the use of the combination of MRI and IHC for the prediction of high-risk EC is controversial. The aim of this study was to evaluate the value of preoperative MRI and IHC examination in prediction of patients with high-risk EC.Methods: This retrospective case-control study was conducted from January 1, 2018 to May 1, 2021 at two hospitals. A primary cohort (n=102) comprised patients with histologically confirmed EC in one hospital between January 1, 2018 and May 31, 2020. An additional external cohort (n=35) comprising patients with histologically confirmed EC in a different hospital from January 1, 2020 to May 1, 2021 was included for validation. Imaging features including tumor size, tumor margin, relative T2 value, tumor signal intensity on diffusion-weighted imaging (DWI), T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) were determined from preoperative MRI images. IHC markers including ER, PR, p53 and Ki67 were determined through IHC staining of preoperative curettage specimen. Patients were divided into high-risk and low-intermediate-risk group based on the final histological results. Differences between categorical and numerical variables were assessed using chi-square test and independent-sample t-test, respectively.Multivariate binary logistic regression analyses were used for construction of the prediction model A fusion prediction model was constructed by combining MRI features and IHC markers. The predictive performance of the model was then validated using the external cohort.Results: Imaging and IHC markers were significantly associated with risk ranks. Model 1 based on MRI features showed an area under the curve (AUC) of 0.822 [95% confidence interval (CI), 0.741-0.903] whereas Model 2 based on IHC markers showed an AUC of 0.894 (95% CI, 0.829-0.960). Notably, model 3 integrating independent MRI and IHC risk factors demonstrated good calibration and high differentiation ability with an AUC of 0.958 (95% CI, 0.923-0.993), and showed good discrimination with an AUC of 0.84 (95% CI, 0.677-0.942) using the external validation set.Conclusions: This study proposes a comprehensive predictive model comprising MRI and IHC features as a powerful tool for preoperative risk stratification to assist in clinical decision-making for EC patients.

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“…Endometrial cancer, approximately 16% at the time of diagnosis, is detected at an advanced stage [16]. According to the surgicalpathological staging, Dane et al [17], found that The 5-year DFS rate was 90% in stage I, 66% in stage II, 32% in stage III and 60% in stage IV and the 5-year OS rate was 95% in stage I, 89% in stage II. 49% in stage III, and 30% in stage IV .…”

Section: Discussionmentioning

confidence: 99%

The struggle against endometrial cancer: ten years of experience of a tertiary center

et al. 2021

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The effect of myometrial invasion on prognostic factors and survival analysis in endometrial carcinoma

Cited by 12 publications

References 19 publications

Correlation Between Frozen Section and Definitive Diagnosis in High-Risk Endometrial Carcinoma: Retrospective Analysis

Correlation Between Frozen Section and Definitive Diagnosis in High-Risk Endometrial Carcinoma: Retrospective Analysis

Preoperative MRI and immunohistochemical examination for the prediction of high-risk endometrial cancer

The struggle against endometrial cancer: ten years of experience of a tertiary center

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