Patterns of distant metastases in patients with endometrial carcinoma: A SEER population-based analysis.

Abstract

e17109 Background: Endometrial carcinoma is the most common gynecology malignancies in the worldwide. The clinical outcome of endometrial carcinoma is excellent, with disease specific survival rate over 90% in early stages. However, the prognosis of metastatic endometrial carcinoma is poor and the pattern of distant metastases has not been well characterized. In the present study, we sought to assess the incidence and prognosis of different distant metastatic sites in endometrial carcinoma. Methods: Patients who were diagnosed with endometrial carcinoma between 2010 and 2015 were identified according to the following criteria in the Surveillance, Epidemiology, and End Results (SEER) database: (1) confirmed age and older than 18 years old; (2) enrolled patients should have confirmed distant visceral metastatic status information. Kaplan-Meier analysis and log-rank tests were used to estimate the overall survival (OS) between difference groups. Data were analyzed with GraphPad Prism (version 7.01, GraphPad Software, USA), and R (version 4.3.1, R Development Core Team). Results: A total of 73328 patients with endometrial carcinoma were included. Median age of diagnosis was 62 years and 80.3% of patients were white. 92.8% of patents have received surgery. 4.2% of patients (3053/73328) suffered at least one site of distant metastases. The most common metastasis site was lung (1331/73328, 1.82%), followed by distant lymph nodes (1191/72703, 1.6%), liver (661/73328, 0.9%), bone (475/73328, 0.65%) and brain (133/73328, 0.18%). Median OS was 15 months, 4 months, 7 months, 9 months and 8 months for pure distant lymph node, brain, bone, lung and liver metastases, respectively. Furthermore, metastatic sites showed significant impact on OS in univariate analysis. Multivariate analysis with COX proportional regression model showed that distant metastatic sites were independent prognostic factors of OS. Conclusions: Lung is the most common distant metastatic site of endometrial carcinoma. Patients with pure distant lymph node metastasis exhibited the best overall survival, while patients with brain metastases had worst clinical prognosis compared with other metastatic sites.

From endometrium to fingernail bed: histological evaluation of a rare cutaneous metastasis

“…Once in the bloodstream, the tumour cells circulate throughout the body. They can then extravasate or exit the bloodstream at distant sites 6. After extravasation, tumour cells can colonise new tissue, in this case, the skin and nail bed of the finger 7.…”

“…After extravasation, tumour cells can colonise new tissue, in this case, the skin and nail bed of the finger 7. Certain tumours exhibit a tropism for specific tissues; molecular interactions between tumour cells and the microenvironment of the metastatic site might play a role in this selective colonisation 6 8. Additionally, factors such as tumour-induced immunosuppression could contribute to this phenomenon 7…”

Detection of metastatic lymph node and sentinel lymph node mapping ​using mannose receptor targeting in in vivo mouse footpad tumor models and rabbit uterine cancer models

“…Endometrial cancer is the most common gynecologic cancer in developed countries 1 , and its incidence is also rapidly increasing 2 . Endometrial cancer is mostly diagnosed at an early stage 3 ; however, for women with advanced-stage cancers, the prognosis is poor 4 , and lymph node (LN) metastasis status is greatly related to the outcome of the disease 5 . Additionally, LN metastasis status can help identify patients who require adjuvant therapy and select the most efficacious treatment 6 .…”

Molecular profiling of primary endometrioid endometrial cancer and matched lung metastases: CTNNB1 mutation as a potential driver

“…In a single-institution retrospective review of recurrent EC, the most frequently observed sites of relapse were lymph nodes (46 %), vagina (42 %), peritoneum (28 %) and lung (24 %) ( Sohaib et al, 2007 ). Surveillance, Epidemiology and End Result (SEER) population-based studies of patients with EC reported the most common sites of distant metastases were lung (1.5–1.8 %), followed by liver (0.8–0.9 %), bone (0.6–0.7 %), and brain (0.2 %) ( Li et al, 2019 , Mao et al, 2020 ). The molecular processes underpinning distant metastasis in EC are not well understood.…”