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

Abstract

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.

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

“…This study found that tumor grade was an independent prognostic factor for OS and CSS, which was consistent with others (16)(17)(18). Our multivariable analysis showed that patients with non-endometrioid and sarcoma subtypes had worse survival than those with endometrioid subtype, consistent with the findings reported by Liu et al (4).…”

“…Compared with other tumors, bone metastasis is relatively uncommon in EC, with an incidence 0.6% ( 3 ). Among patients in stage IV EC, bone metastasis occurred in 6.8% of patients ( 4 ). Distant organ metastasis usually predicts a poor prognosis ( 5 ).…”

“…Distant organ metastasis usually predicts a poor prognosis ( 5 ). Although 5-year overall survival (OS) of EC was estimated around 80% in patients without metastatic disease ( 1 , 2 ), metastatic EC patients experienced extremely poor prognosis with 5-year OS less than 20% ( 3 , 4 ). Common treatment methods for EC include surgery, radiotherapy, as well as systemic therapies.…”

Clinicopathological study of organ metastasis in endometrial cancer

“…There are few studies on distant metastasis in patients with EC, and most of them focus on single metastasis site or specific stage. Liu et al [20] through the study of 2948 patients with stage IV EC from 2010 to 2014, found that the most common metastasis site of stage IV EC was the lung, while the survival rate of patients with brain metastasis was the worst. Ignatov et al [21] described the recurrence pattern of EC according to the risk characteristics through a 7-year follow-up of 2177 EC patients.…”

LncRNA RUNX1-IT1 is Downregulated in Endometrial Cancer and Binds to miR-21 Precursor to Suppress Its Maturation

“…4 However, metastases to distant sites such as the bladder, rectum, ovary, and vagina are common in EC patients. 5 Due to the lack of effective treatment strategies, the 5-year overall survival rate of patients with distant metastatic EC is below 20%. 6 Therefore, novel therapies are needed to further improve patients' survival.…”