Clinicopathological prognostic factors and the role of cytoreduction in surgical stage IVb endometrial cancer: A retrospective multi-institutional analysis of 248 patients in Japan

Eto, Takako; Saito, Toshiaki; Kasamatsu, Takahiro; Nakanishi, Tōru; Yokota, Harushige; Nogawa, Takayoshi; Yoshikawa, Hiroyuki; Kamura, Toshiharu; Konishi, Ikuo

doi:10.1016/j.ygyno.2012.08.012

Cited by 27 publications

(46 citation statements)

References 28 publications

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“…Furthermore, independent prognostic factors of survival were different for liver and lung metastases. The lungs accounted for the highest proportion of distant metastases, followed by the liver, bone, and brain, consistent with previous studies . Poor outcomes were associated with being 65 years or older and black race, which agrees with the findings of Sud et al .…”

Section: Discussionsupporting

confidence: 92%

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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Section: Discussionsupporting

confidence: 92%

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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“…Nevertheless, there is a consensus on the necessity of systemic treatment, since disease in this stage should be accepted as systemic. Eto et al reported that chemotherapy with or without radiotherapy was a determining prognostic factor for survival (20). Similar results were stated in the study of Ayhan et al (22).…”

Section: Discussionsupporting

confidence: 70%

“…Nevertheless, in these studies, omentectomy was performed as infracolic omentectomy or omental biopsy. Furthermore, 11%-71.4% of the reported omental metastases were micrometastases (8)(9)(10)(11)(12)(13)(14)(15)20). It is not possible to say whether there were microscopic metastases or not in the remaining omentum after subtotal omentectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Although stage IVB endometrial cancer includes a heterogeneous group of patients, age, extra-abdominal spread, lymph node metastases, adjuvant therapy, grade, cervical invasion, depth of myometrial invasion, performance status of the patients, and especially aggressive surgery were all reported to determine survival (20)(21)(22). In these studies and in a meta-analysis evaluating cytoreductive surgery in patients with primary and recurrent endometrial cancer, extent of surgery was shown to be the main factor determining survival in patients with stage IVB endometrial cancer (20)(21)(22)(23). In a study by Bristow et al (21), patients who had optimal debulking surgery were found to survive 3 times longer than patients for whom optimal deb ulking could not be achieved.…”

Section: Discussionmentioning

confidence: 99%

“…It is also inappropriate to compare these results with the Japanese multi-center study evaluating stage IVB endometrial cancer. In the study by Eto et al (20), 248 patients were analyzed, and only 58% of these patients had omental metastasis, since 38% had extra-abdominal spread. Eventually, the patient population of the current study was limited compared to the patients in the studies analyzing cases with stage IVB endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

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What is the importance of omental metastasis in patients with endometrial cancer?

Turan

Üreyen

Karalök

et al. 2014

J Turkish German Gynecol Assoc

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Objective: To identify surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastasis from endometrial cancer. Material and Methods:Patients with endometrial cancer operated on between 1993-2012 in our hospital and who had omental metastases were included. Patients with either uterine sarcoma or synchronous tumors were excluded.Results: Omentectomy was performed in 811 patients with endometrial cancer, and omental metastasis was found in 48 (5.9%) patients.Tumor type was endometrioid cancer in 26 patients. Omental metastasis was macroscopic and microscopic in 60% and 40% of the patients, respectively. Total omentectomy increased the chance of detection of the microscopic metastases. Among the patients with omental metastasis, 68.8% had positive peritoneal cytology, 66.7% had adnexal involvement, 60.5% had metastases in the lymph nodes, 47.9% had cervical involvement, and 29.2% had serosal involvement; 43.8% of these patients had intra-abdominal spread beyond the omentum, adnexa, and peritoneal cytology. Two-year disease-free survival (DFS) was 28.2%, and 2-y overall survival (OS) was 40%. The depth of myometrial invasion, grade, cytology, and status of pelvic lymph nodes affected 2-y DFS, while cervical invasion and cytology affected 2-y OS. Conclusion:Omental metastasis in endometrial cancer means poor prognosis, and two-thirds of these patients are lost at the end of the second year. Although total omentectomy increases the chance of the detection of micrometastases, its effect on survival is controversial. New treatment modalities are necessary in this patient group. (J Turk Ger Gynecol Assoc 2014; 15: 164-72) Key words: Endometrial cancer, omental metastases, survival Received: 03 June, 2014 Accepted: 25 July, 2014 What is the importance of omental metastasis in patients with endometrial cancer? Abstract of patients involving all stage IV patients. Patients without other intra-abdominal metastases and patients with microscopic omental metastases were included in these studies. The reports, except the studies mentioned above, were presented as very small case series or case reports. The patients with omental metastases were not analyzed with regard to surgico-pathologic characteristics and survival, and the factors determining survival have not been identified sufficiently in endometrial cancer. In this study, the determination of surgico-pathologic factors, survival, and the factors determining survival in patients with omental metastases from endometrial cancer is aimed. Material and Methods Study PopulationThe records and pathologic reports of patients with endometrial cancer who were operated in our clinic between 1993 and 2012 were analyzed retrospectively. The patients with omental metastasis were included. Patients with uterine sarcoma, endometrioid carcinoma involving a sarcoma component, or synchronous tumors were excluded. The data related to demographic characteristics, intraoperative findings, debulking status, surgico-pathologic results, pat...

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Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources

Ribeiro

Cintra

Barrozo

et al. 2019

Journal of Surgical Oncology

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Background Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines. Objectives The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers. Methods The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations. Results For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives. Conclusions It is possible to provide adequate treatment for most EC patients in resource‐limited areas, but the first option should be referral to specialized centers with more resources.

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Clinicopathological prognostic factors and the role of cytoreduction in surgical stage IVb endometrial cancer: A retrospective multi-institutional analysis of 248 patients in Japan

Cited by 27 publications

References 28 publications

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

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

What is the importance of omental metastasis in patients with endometrial cancer?

Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources

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