Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy

Chen, Hui-Hua; Ting, Wan-Hua; Sun, Hsu-Dong; Wei, Ming-Chow; Lin, Ho‐Hsiung; Hsiao, Sheng-Mou

doi:10.3390/ijerph17165941

Cited by 6 publications

(8 citation statements)

References 23 publications

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“…In this study, we found the presence of para-aortic lymph node metastasis as the sole independent predictor of RFS in the multivariable analysis (Table 3), compatible with the study result of a retrospective study by Chen et al (hazard ratio = 11.11, p < 0.001) [14]. Similarly, lymph node status is considered to be the most important predictor for cancer outcome in a review article by Pijnenborg et al [15].…”

Section: Discussionsupporting

confidence: 88%

Predictors for the Recurrence of Clinically Uterine-Confined Endometrial Cancer and the Role of Cytokeratin Immunohistochemistry Stain in the Era of Sentinel Lymph Node Mapping

Ting

Hsieh

Chen

et al. 2022

Cancers

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Background: The primary objective of this study was to elucidate the predictors for cancer recurrence in women with clinically uterine-confined endometrial cancer in the era of sentinel lymph node (SLN) mapping. Methods: All consecutive women with clinically determined uterine-confined endometrial cancer who had lymph node assessment by either SLN mapping or traditional pelvic lymphadenectomy were reviewed. Results: Women in the SLN mapping group had lower total dissected pelvic nodes, lower incidence of para-aortic lymph node dissection, less intraoperative blood loss and lower complication rates, but a longer operation time compared to the traditional lymphadenectomy group. Para-aortic lymph node metastasis (hazard ratio = 7.60, p = 0.03) was the sole independent predictor for recurrence-free survival. In addition, the utilization of cytokeratin immunohistochemistry stain detected more lymph node metastases (adjusted odds ratio = 3.04, p = 0.03). Recurrence-free survival did not differ between SLN mapping and traditional lymphadenectomy groups (p = 0.24). Conclusions: Para-aortic lymph node metastasis is an important predictor of cancer recurrence. Women with negative hematoxylin and eosin stain should undergo cytokeratin immunohistochemistry stain to increase the detection rate of positive lymph node metastasis. Besides, the probabilities of recurrence seem to be similar between SLN mapping and traditional lymphadenectomy groups in women with clinically uterine-confined endometrial cancer.

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Section: Discussionsupporting

confidence: 88%

Predictors for the Recurrence of Clinically Uterine-Confined Endometrial Cancer and the Role of Cytokeratin Immunohistochemistry Stain in the Era of Sentinel Lymph Node Mapping

Ting

Hsieh

Chen

et al. 2022

Cancers

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“…Since UPSC is a rare category of endometrial cancer, the patients with poor prognosis and have been diagnosed at an advanced stage. Studies have explored the survival characteristics of advanced stage endometrial cancer (Goodman et al, 2019, Chen et al, 2020. Solmaz et al (2016) found that LVSI was a significant covariate for the survival of endometrial cancer patients with UPSC but in our study we found it is not statistically significant.…”

Section: Discussioncontrasting

confidence: 78%

Accelerated Failure Time Models with Applications to Endometrial Cancer Survival Data

Tripathy

Swain

Sarangi

et al. 2023

JRSS

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The objective of this study is to determine the significant predictors of endometrial cancer using accelerated failure time models (AFTM). We have demonstrated the applications of AFTM viz. Exponential, Weibull, Log-normal, Log-logistic, Gompertz, Gamma and Generalized Gamma AFTM, as an alternative of Cox proportional hazard model. Data for the analysis was collected from Acharya Harihar Post Graduate Institute of Cancer (AHPGIC), Cuttack, Odisha during the period 2016–20. Based on the lowest Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) value, the Weibull AFTM has been chosen as the best fitted AFT model. The predictors such as age, comorbidity, tumor size, isolated para-aortic and adnexa have been found as significant predictors (p-value < 0.05) to explain the survival of endometrial cancer patients. Hence, by optimizing different treatments, based on such prognostic factors plays an important role in managing endometrial cancer at an early stage.

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“…All‐cause mortality was the most frequently reported outcome ( n = 31), followed by recurrence ( n = 20) and endometrial cancer‐specific mortality ( n = 19; Table 1). Elevated BMI was associated with increased all‐cause mortality, endometrial cancer‐specific mortality, and cancer recurrence in 12, 15–17,21,26,48,51–53,64,67,69 2, 51,59 and 2 52,69 studies, respectively. One study noted a negative relationship between BMI and endometrial cancer‐specific mortality 55 .…”

Section: Resultsmentioning

confidence: 95%

“…Most of studies were conducted in Europe ( n = 20) 12,13,15,18,21,22,27,43–55 and North America ( n = 18) 19,20,23–26,56–67 . The remaining studies were conducted in Asia ( n = 4), 14,68–70 Oceania ( n = 2), 17,71 and South America ( n = 1) 72 . Only Martra et al 16 included participants from more than one location (USA and Italy).…”

Section: Resultsmentioning

confidence: 99%

Obesity and mortality among endometrial cancer survivors: A systematic review and meta‐analysis

et al. 2021

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Summary Excess body fat is a major risk factor for endometrial cancer incidence, but its impact on recurrence and survival remains unclear. The aim of this systematic review and meta‐analysis was to assess the association between excess body fat with recurrence, cancer‐specific, and all‐cause mortality among endometrial cancer survivors. We searched MEDLINE and EMBASE databases up to July 2021. Risk of bias was assessed with the Ottawa Newcastle Scale. Random effects models estimated pooled hazard ratios for the main associations between body mass index (BMI) and survival outcomes and stratified by endometrial cancer type. Potential heterogeneity and publication bias were evaluated with sensitivity analyses, funnel plots, and Egger's test. Forty‐six studies were included, of which 45 estimated body fat with BMI and six used direct waist circumference measures or CT/MRI scans. Higher BMI (≥30 kg/m2) was associated with increased all‐cause mortality (HR = 1.34, 95%CI = 1.12–1.59) and recurrence (HR = 1.28, 95%CI = 1.06–1.56). In sub‐group analysis, associations between higher BMI and all‐cause mortality were observed for both Types I and II survivors, while recurrence associations were only significant among Type I cases. Obesity at endometrial cancer diagnosis was associated with increased cancer recurrence and all‐cause mortality among endometrial cancer survivors but not endometrial cancer‐specific mortality.

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Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy

Cited by 6 publications

References 23 publications

Predictors for the Recurrence of Clinically Uterine-Confined Endometrial Cancer and the Role of Cytokeratin Immunohistochemistry Stain in the Era of Sentinel Lymph Node Mapping

Predictors for the Recurrence of Clinically Uterine-Confined Endometrial Cancer and the Role of Cytokeratin Immunohistochemistry Stain in the Era of Sentinel Lymph Node Mapping

Accelerated Failure Time Models with Applications to Endometrial Cancer Survival Data

Obesity and mortality among endometrial cancer survivors: A systematic review and meta‐analysis

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