Prognostic value of different metastatic sites for patients with FIGO stage IVB endometrial cancer after surgery: A SEER database analysis

Abstract

Objective This study aimed to investigate the association between different metastatic sites and survival in endometrial cancer (EC) patients with International Federation of Gynecology and Obstetrics (FIGO) stage IVB disease. Methods FIGO stage IVB patients with EC were selected from the surveillance, epidemiology, and end results database. Overall survival (OS) and cause‐specific survival (CSS) were analyzed with Kaplan‐Meier analysis and log‐rank tests. Univariate and multivariate Cox proportional hazard models were used to identify the prognostic factors for OS and CSS. Results A total of 929 FIGO stage IVB patients with EC were identified. Patients with peritoneum metastasis were associated with significantly better OS and CSS compared to those with organ‐specific metastasis (median OS: 29 vs 19 months, P = .005; median CSS: 47 vs 25 months, P < .001). Moreover, the survival superiority of peritoneum metastasis remained significant when organ‐specific metastasis was further classified into specific single‐organ metastasis. The multivariate analysis also indicated that compared with peritoneum metastasis, bone, brain, and lung metastasis were independent prognostic factors for worse OS. Similarly, distant lymph node, bone, brain, liver, and lung metastasis were associated with worse CSS. Conclusion Metastatic sites affected prognosis in FIGO stage IVB patients with EC. Patients with peritoneum metastasis had significantly better survival outcomes than those with organ‐specific metastasis.

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

“…Our analysis found that lung was the most common metastatic organ (46.2%) in EC patients with bone metastasis, compared with other metastatic organs. In contrast to previous studies ( 7 , 22 ), lung metastasis did not remain significant in multivariable analysis. Consistent with previous studies ( 3 , 22 ), liver or brain metastasis were independent predictors of decreased OS and CSS in the multivariable analysis.…”

“…In contrast to previous studies ( 7 , 22 ), lung metastasis did not remain significant in multivariable analysis. Consistent with previous studies ( 3 , 22 ), liver or brain metastasis were independent predictors of decreased OS and CSS in the multivariable analysis. Therefore, aggressive management of liver and brain metastases may be helpful in prolonging outcomes in EC patients with bone metastasis.…”

“…However, few data factually support their survival benefits in EC patients with bone metastasis. This study emphasized that good outcomes were associated with surgery and radiotherapy of primary tumors, and systemic chemotherapy, which agrees with the previous findings ( 12 , 22 ). We first found that surgery or radiotherapy of primary tumors were independent predictors associated with increased OS.…”

Clinical Characteristics, Treatment Modalities, and Potential Contributing and Prognostic Factors in Patients with Bone Metastases from Gynecological Cancers: A Systematic Review

“…For EC, we founded 11 retrospectives studies. In these studies, the median survival time after bone metastases diagnosis ranged from 4.0 to 18.0 months [ 24 , 25 ], with a study that underlined the difference in median survival between patients with Stage III (4 months) and patients with Stage I (17.5 months). The bone metastases occurrence in this cohort of patients ranged from 0.5% [ 27 ] to 15.4% [ 22 ]; this difference could be due to the different number of enrolled patients, which ranged from 403 [ 23 ] to 69,027 in the case of the lowest occurrence [ 27 ].…”

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