Medical Morbidities in Endometrial Cancer Patients

Tangjitgamol, Siriwan; Khunnarong, Jakkapan; Srijaipracharoen, Sunamchok

doi:10.1097/igc.0000000000000291

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…It is still classified by the World Health Organization as a mixed epithelial and mesenchymal tumor base on histomorphologic appearance (Wells et al, 2014). Our previous works had included data of CS patients in the studies of endometrial carcinoma addressing the issues of adjuvant therapy (Tangjitgamol et al, 2015), medical morbidities (Tangjitgamol et al, 2014) or other cancers (unpublished observations), however, these studies did not focus outcomes by histologic subtypes. Base on the WHO classification and by the fact that most studies compared different clinical features of CS with other uterine sarcomas, we identified more number of CS in recent years and compared it with other sarcomas in this study.…”

Section: Discussionmentioning

confidence: 99%

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Potikul¹,

Tangjitgamol²,

Khunnarong³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was 54.0±11.9 years (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.Keywords: Uterine sarcoma -clinical characteristics -survival -prognostic factors -Thailand RESEARCH ARTICLE Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in ThailandChalermrat Potikul, Siriwan Tangjitgamol*, Jakkapan Khunnarong, Sunamchok Srijaipracharoen, Thaovalai Thavaramara, Kamol Pataradool the mainstay of treatment (Prat, 2009). Slightly different from its carcinoma counterpart, ovarian preservation and exemption of lymph node resection are sometimes acceptable particular in younger age patients and in those with certain types of sarcoma (Leitao et al., 2003;Kapp et al., 2008). Adjuvant therapy after surgery has evolved over the years without a clear benefit on survival (Cearbhail and Hensley, 2010;Rauh-Hain and Carmen, 2013;Cantrell et al., 2015).Despite being derived from various cellular origins and having different pathologic features, most sarcomas have aggressive behavior, high rates of recurrence and poor prognosis even when diagnosed at an early st...

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Section: Discussionmentioning

confidence: 99%

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Potikul¹,

Tangjitgamol²,

Khunnarong³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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“…According to Brinton et al [8], EC is related to previous diagnoses of thyroid diseases (RR=1.52, 95% CI 1.17-1.98) and obesity (2.05, 1.40-3.00), but the data do not show which specific types of thyroid disease were more strongly linked to the risk. Siriwan et al [9] examined 335 patients with EC and found that 220 (65.7%) had medical co-morbidities, of which two or more components of metabolic syndrome was the most common (72.3%). Thyroid dysfunction was the second most common co-morbidity and was observed in 8.2% of patients, whereas the incidence of hypothyroidism was 4.2%.…”

Section: Epidemiology Of Hypothyroidism In Ecmentioning

confidence: 99%

Relationship between Hypothyroidism and Endometrial Cancer

2019

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Thyroid dysfunction is involved in several types of carcinoma. Hypothyroidism is one of the most common medical morbidities among patients with endometrial cancer; however, the related mechanism is unclear. Among the risk factors related to endometrial cancer, hypothyroidism interacts with metabolic syndrome, polycystic ovarian syndrome and infertility or directly acts on the endometrium itself, which may influence the development and progression of endometrial cancer. We summarize recent studies on the relationship between hypothyroidism and endometrial cancer and its risk factors to provide references for basic research as well as for clinical treatment and prognostic evaluation.

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“…Data collected were age, medical morbidities (particularly components of metabolic syndrome such as diabetes mellitus, dyslipidemia, hypertension, and obesity), International Federation of Gynecology and Obstetrics (FIGO) stage of disease according to the FIGO 2009 criteria, fundus/body or lower uterine segment (LUS) site of tumor, histopathology, tumor grade, adjuvant therapy, other cancers, follow-up period, and living status. Data of medical morbidities were partly taken from our data set of a previous report that focused on medical morbidities of EC patients [ 14 ]. Stages of patients who were treated prior to 2009 were reassigned according to FIGO 2009 staging criteria.…”

Section: Methodsmentioning

confidence: 99%

Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

2015

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ObjectiveTo evaluate the prevalence and features of non-endometrial cancers in Thai endometrial cancer (EC) patients.MethodsEC patients treated in our institution were identified and the following data were collected: age, EC stage, histopathology, adjuvant therapy, other cancers, living status, and cause of death.ResultsThe mean age of the 344 patients was 56.8±10.8 years. Fifty (14.5%) had other synchronous and metachronous cancers. Mean ages of the patients with or without other cancers were not significantly different, 55.7±10.04 years versus 57.1±11.0 years, respectively (p=0.358). History of any cancer in the family and tumor in the lower uterine segment were more frequent among the patients with other cancers (6.0% vs. 1.7%, p=0.095; 12.0% vs. 1.0%, p<0.001; respectively). Six patients had ≥2 other cancers. Ovarian, breast, and colon were the three most common other cancers. After a median follow-up of 57.1 months, 18.3% of patients had died: 30.0% of patients with other cancers and 16.3% of those without other cancers. The corresponding EC deaths were 14.0% and 11.2%. The 5-year overall survival was significantly lower in patients who had other cancers: 79.3% (95% confidence interval [CI], 68.3 to 90.3) vs. 86.0% (95% CI, 81.7 to 90.3) than in those without (p=0.023). However, the corresponding disease-specific survival was not significantly different: 85.1% (95% CI, 75.5 to 94.7) compared with 89.0% (95% CI, 85.1 to 92.9), respectively (p=0.514).ConclusionThai EC patients had a high incidence of other cancers. Overall survival of EC patients who had other cancers was worse than those without, while disease-specific survival was not significantly different.

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Medical Morbidities in Endometrial Cancer Patients

Cited by 12 publications

References 17 publications

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Uterine Sarcoma: Clinical Presentation, Treatment and Survival Outcomes in Thailand

Relationship between Hypothyroidism and Endometrial Cancer

Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

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