Tumor size, depth of invasion, and histologic grade as prognostic factors of lymph node involvement in endometrial cancer: A SEER analysis

Vargas, Roberto; Rauh‐Hain, J. Alejandro; Clemmer, Joel; Clark, Rachel M.; Goodman, Annekathryn; Growdon, Whitfield B.; Schorge, John O.; Carmen, Marcela G. del; Horowitz, Neil S.; Boruta, David M.

doi:10.1016/j.ygyno.2014.02.011

Cited by 139 publications

(143 citation statements)

References 20 publications

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“…According to the Surveillance, Epidemiology and End Results (SEER) data, low-risk EC patients represent approximately 61% of endometrioid ECs grossly confined to the uterus [22,23]. Although the recurrence rate is very low in this subgroup of patients (1-7%), the absolute number of recurrences in low-risk EC seems to be actually considerable as approximately 70% of women with EC are given a diagnosis while the disease is confined to the uterus [24].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

et al. 2018

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Aim: The aim of this study was to investigate the risk factors for recurrence in patients with low-risk endometrial cancer (EC). Patients and Methods: This retrospective study was performed using 10 gynecological oncology department databases. Patients who met the following criteria were included in the study: (a) endometrioid-type histology, (b) histological grade 1 or 2, (c) no or < 50% myometrial invasion, (d) no intraoperative evidence of extrauterine spread, and (e) the patient underwent at least a pelvic lymphadenectomy. Recurrence was detected in 56 patients who were histologically diagnosed with low-risk EC, and these patients made up the case group. A total of 224 patients with low-risk EC without recurrence were selected (control group) using a dependent random sampling method. The case and control groups were match-paired in terms of grade, stage, and operative technique. Results: Lymphovascular space invasion (LVSI) (odds ratio (OR) 5.8, 95% confidence interval (CI) 2.0-16.9; p = 0.001) and primary tumor diameter (PTD) ≥ 20 mm (OR 6.6, 95% CI 2.7-15.8; p < 0.001) were found to be independent risk factors for recurrence in women with low-risk EC. Conclusion: The presence of LVSI and PTD ≥ 20 mm seem to be significant risk factors for recurrence in women with low-risk EC.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

et al. 2018

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“…By that way greater than 50% myometrial invasion is significant for lymph node invasion (p<0.05). Myometrial invasion is a prognostic factor for extra uterine spread (18) and an important predictor for pelvic and para-aortic lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Besides depth of myometrial invasion is an important prognostic factor and determination of myometrial invasion is essential to decide surgical staging and adjuvant treatment options (18). High grade histology and deep myometrial invasion are associated with significantly higher incidence of retroperitoneal nodal metastases (17,19,20).…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Myometrial Invasion Between Other Prognostic Parameters in Endometrial Cancer

Bakır

Tahaoğlu

Erdoğdu

et al. 2017

Gynecol Obstet Reprod Med

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OBJECTIVE:The aim of this study is to investigate the relationship between deep myometrial invasion and other prognostic factors in endometrial cancer. Recurrence rates, disease free survival and overall survival rates were evaluated in endometrial cancer patients with MI>50%. STUDY DESIGN:A total of 132 patients with endometrial cancer who underwent surgical treatment between 2001 and 2011 were identified. Demographic, clinicopathological, surgical/adjuvant treatment and follow-up data were extracted. RESULTS:Pelvic lymph node invasion ratio was 28,9% and para-aortic lymph node invasion ratio was 15,5% in patients with myometrial invasion is greater than 50%. Other prognostic factors especially lympho-vascular space invasion and pelvic/para-aortic lymph node metastasis were significantly higher when myometrial invasion is above 50% and also there was significant difference in recurrence rates, overall survival and disease free survival rates between patients with superficial and deep myometrial invasion (p<0.05). CONCLUSION:Myometrial invasion is an important prognostic parameter and can be determined intraoperatively to decide whether to perform pelvic and para-aortic lymph node dissection.

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“…Whilst most patients with early stage disease have a good prognosis, the prognosis for patients with recurrent or advanced disease at presentation, i.e., advanced stage, incurable by surgery or radiotherapy, is poor. The most important parameter to elaborate the surgical stage is the depth of myometrial invasion (3,4). The percentage of myometrial invasion (%MI) is routinely determined in hysterectomy specimens and categorized as greater than or less than 50% and it is one of the parameters used in the determination of the need for adjuvant therapy (5).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of tumor‑free distance and depth of myometrial invasion as prognostic factors in endometrial cancer

et al. 2018

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Abstract. The aim of the study was to investigate whether the tumor free distance (TFD), which is the distance in millimeters between the deepest point of invasion and the serosal surface, and absolute depth of invasion (DMI), the distance in millimeters between the endomyometrial junction and the deepest point of myometrial invasion, are useful in surgical staging and in predicting prognosis. The present study retrospectively analyzed 62 cases of endometrial carcinoma with complete surgical staging, carried out over a 4 and half-year period (January 2003 to June 2007). All surgicopathological findings including surgical stages, histological type and grade, myometrial invasion, lymphovascular space invasion, cervical and adnexal involvement, and lymph node metastasis were abstracted from medical records and pathological reports. Univariate and multivariate analyses were performed comparing TFD, DMI and the percentage of mypmetrial invasion (MI) with established prognostic factors. A total of 62 patients were included in the study. A total of 52 (84%) had endometrioid carcinomas and 31 patients (60%) had grade 1 cancer. The deepest MI was <50% in 32 patients (52%). Median DMI was 2.7 mm (range 0-15 mm). Median TFD was 3 mm (range 0-19 mm). There was lymphovascular space invasion (LVSI) in 11 patients (17.5%), cervical involvement in 11 patients (17.5%), extra-uterine extension in 9 cases (14%) and lymph node metastasis in 12 patients (22%). It was demonstrated that 50% MI was significantly associated with prognostic factors (cervical involvement, type 2 carcinomas and LVSI, and was a significant predictor of the 5-year overall survival rate and recurrence-free survival (P=0.05, P=0.01). No significant association was observed between DMI and TFD with clinicopathological parameters and survival rates. The importance of DMI in predicting recurrence of disease was observed to be highest in terms of sensitivity and specificity. The cut-off value with the highest sensitivity and specificity crossing the receive operating characteristic curve was calculated to be 3 mm for DMI and 2.5 mm for TFD. The results indicate that DMI is a superior predictive factor of recurrence of the disease compared with TFD. However, further studies are required in order to prove the prognostic usefulness of these parameters and then to improve management of endometrial cancer. IntroductionEndometrial carcinoma is the most common of all the gynecologic malignancies and its incidence is rising (1,2). Surgical staging is an important determinant of adjuvant therapy. Whilst most patients with early stage disease have a good prognosis, the prognosis for patients with recurrent or advanced disease at presentation, i.e., advanced stage, incurable by surgery or radiotherapy, is poor. The most important parameter to elaborate the surgical stage is the depth of myometrial invasion (3,4). The percentage of myometrial invasion (%MI) is routinely determined in hysterectomy specimens and categorized as greater than or less than 50% and it is one of the ...

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Tumor size, depth of invasion, and histologic grade as prognostic factors of lymph node involvement in endometrial cancer: A SEER analysis

Cited by 139 publications

References 20 publications

Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

The Relationship of Myometrial Invasion Between Other Prognostic Parameters in Endometrial Cancer

Evaluation of tumor‑free distance and depth of myometrial invasion as prognostic factors in endometrial cancer

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