Association of Tumor Size With Prognosis in Patients With Resectable Endometrial Cancer: A SEER Database Analysis

Abstract

This study aimed to explore the relationship between tumor size (Ts) and prognosis in endometrial cancer (EC). A total of 52,208 patients with EC who underwent total hysterectomy were selected from the Surveillance, Epidemiology, and End Results Program database. Overall survival (OS) and endometrial cancer-specific survival (ESS) were chosen as survival outcomes. The Cox proportional hazards model was used to explore the effect of Ts on prognosis. The restricted cubic splines based on the Cox regression model were used to determine the nonlinear relationship between Ts and survival. When Ts was analyzed as a categorical variable, the risk of death increased with Ts, with the highest risk in patients with Ts > 9 cm with regard to all-cause death (ACD) (hazard ratio [HR] 1.317; 95% confidence interval [CI], 1.196-1.450; P < 0.001) and endometrial cancer-specific death (ESD) (HR, 1.378; 95% CI, 1.226-1.549; P < 0.001). As a continuous variable, Ts showed a nonlinear relationship with ACD (HR, 1.061; 95% CI, 1.053-1.069; P < 0.001) and ESD (HR, 1.062; 95% CI, 1.052-1.073; P < 0.001). The risk of mortality increased quickly with Ts when Ts was less than 7.5 cm and then leveled off when Ts was larger than 7.5 cm in all patients. Among patients with lymph node metastasis, the risk of poor prognosis decreased rapidly with Ts when Ts was less than 3.5 cm, and subsequently increased sharply with Ts when Ts ranged from 3.5 cm to 7.5 cm, and then increased slowly when Ts was larger than 7.5 cm (P < 0.001 for nonlinearity). There was a nonlinear relationship between Ts and prognosis in patients with EC. Clinicians should not ignore the impact of small tumors on prognosis in EC patients with lymph node metastasis.

Predictive Value of Magnetic Resonance Imaging in Risk Stratification and Molecular Classification of Endometrial Cancer

“…We found that the maximum tumor diameter significantly differed between risk groups, echoing previous findings that larger tumor sizes are associated with poorer prognoses [35,36]. The invasive features prevalent in the non-low-risk groups align with the findings of other studies, such as those of Maria Ali et al and Stephanie Nougaret et al, which linked tumor size to lymph node metastasis and myometrial invasion depth, respectively [37,38].…”

Development and validation of a nomogram for predicting specific mortality risk: A study of competing risk model based on real endometrial cancer patients

“…In the present study, we found that tumor size was an important prognostic factor. Xuefei Hou et al 32 also found a nonlinear relationship between tumor size and prognosis in patients with endometrial cancer, and the risk of death elevated monotonically with the increase in tumor size.…”

Nghiên Cứu Đặc Điểm Lâm Sàng, Cận Lâm Sàng Và Đánh Giá Kết Quả Phẫu Thuật Trên Bệnh Nhân Ung Thư Nội Mạc Tử Cung Tại Bệnh Viện Ung Bướu Thành Phố Cần Thơ Năm 2021 – 2023

“…Phạm Văn Bùng nghiên cứu năm 2004 ghi nhận tỉ lệ giai đoạn I chiếm tỉ lệ 56,2% [3]. Dữ liệu trong nghiên cứu SEER ghi nhận tỉ lệ này là 69,2% [5]. Các tỉ lệ này thấp hơn trong nghiên cứu của chúng tôi vì báo cáo trên dân số chung, trải dài trên tất cả các giai đoạn của bệnh.…”