Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: A gynecologic oncology group study

Morrow, C. Paul; Bundy, Brian N.; Kurman, Robert J.; Creasman, William T.; Heller, Paul B.; Homesley, Howard D.; Graham, James E.

doi:10.1016/0090-8258(91)90086-k

Cited by 1,190 publications

(501 citation statements)

References 8 publications

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“…Patients with early-stage but ‘binary high-grade’ tumors or advanced-stage with ‘binary low-grade’ tumors should receive adjuvant therapy, which is usually radiation therapy in Western countries [18]and chemotherapy in Japan [19]. Until now, no prospective randomized study on endometrial cancer has looked at the usefulness, as adjuvant therapy, of radiation versus chemotherapy [20].…”

Section: Discussionmentioning

confidence: 99%

The Reproducibility of a Binary Tumor Grading System for Uterine Endometrial Endometrioid Carcinoma, Compared with FIGO System and Nuclear Grading

Sagae

Saito

Satoh³

et al. 2004

Oncology

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Objective: A binary grading system has been proposed to assess the amount of solid growth, the pattern of invasion, and the presence of necrosis, and thereby divide endometrial endometrioid carcinomas into low- and high-grade tumors. We analyzed this system for predicting the prognosis, with respect to inter- and intraobserver reproducibility and treatment modalities. Methods: A total of 200 endometrial carcinomas, based on hysterectomy specimens, were graded according to the binary grading system, for comparison against The International Federation of Gynecology and Obstetrics (FIGO) system and nuclear grading. Results: Both inter- and intraobserver agreement using the binary grading system (ĸ = 0.57; percent agreement: 82% and ĸ = 0.62; 84%) were superior compared with the FIGO system (0.50; 60% and 0.62; 73%) and the nuclear grading (0.23; 49% and 0.43; 65%). Patients with early-stage low-grade tumors had a 98% rate for 5-year survival (5YS). Patients with early-stage high-grade tumors, and those with advanced-stage low-grade tumors, had respectively 86% to 87% rates for 5YS. But patients with advanced-stage high-grade tumors had a 49% rate for 5YS. In binary low-grade early-stage tumors, the patient outcome was better with no adjuvant therapy and chemotherapy, compared with other therapies. Conclusion: A binary grading system was superior to others in permitting greater reproducibility and predicting the prognosis of endometrial cancer patients.

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Section: Discussionmentioning

confidence: 99%

The Reproducibility of a Binary Tumor Grading System for Uterine Endometrial Endometrioid Carcinoma, Compared with FIGO System and Nuclear Grading

Sagae

Saito

Satoh³

et al. 2004

Oncology

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“…In 1991, Morrow and associates reported the GOG data of 895 surgically staged endometrial cancers. In patients with disease confined to the uterus, malignant cytology was independently predicated recurrence (p = 0.02) [13]. Milosevic and associates reviewed the literature in 1992 in patients with Stage I endometrial cancer (FIGO 1971).…”

Section: Review Of Studiesmentioning

confidence: 99%

Is Peritoneal Cytology a Prognostic Factor in Endometrial Cancer?

Foote¹,

Creasman²

2015

JCT

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11 -12, 15 -19). In one of the largest studies, investigators reviewed 14,704 from the SEER's database, demonstrating that malignant peritoneal cytology is associated with decreased survival across Stage I/II disease even when controlled for histology, grade, and other risk factors. Malignant peritoneal cytology should be considered when counseling patients on the risk of recurrence and overall survival of endometrial cancer. However, the role of adjuvant treatment in this setting remains unclear.

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“…The known prognostic factors for the disease-free survival of patients with endometrial carcinoma are: tumor stage, depth of invasion, tumor grade, histological type, age, lymph-vascular space invasion, menopausal state, and progesterone receptor activity. 4,[13][14][15] In the present study, we analyzed the factors predictive of pelvic or distant recurrence in a series of 105 patients with FIGO stage I or II, high risk endometrial cancer. We found an overall recurrence rate of 8.5%.…”

Section: Early Stage Endometrial Carcinoma and Adjuvant Therapy: Detementioning

confidence: 99%

“…Approximately 10% to 15% of patients with early stage endometrial cancer will experience a recurrence. 3,4 However, there is no consensus on the standard adjuvant therapy for stage I -II endometrial cancer. Because most women with endometrial cancer have early stage disease with a good prognosis, it has been difficult to identify the ideal protocol for adjuvant therapy in the small group of women who may be at increased risk for disease recurrence and possibly death.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases

et al. 2008

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Objective:We assessed the prognostic factors and the efficacy of adjuvant therapy and reviewed randomized studies carried out on patients receiving adjuvant therapy with early endometrial carcinoma. Methods: One hundred and five patients that received primary surgical treatment for stage IB, IC and II endometrial cancer were enrolled in this study. The clinical outcomes were compared among the patients with variable prognostic factors and adjuvant treatments. Results: One hundred and five patients fulfilled the eligibility criteria and 46 patients (43.8%) underwent adjuvant therapy. Disease recurrence occurred in nine patients within a median time of 24 months. Cervical involvement was an independent prognostic factor for the disease-free survival rates. Eight of 16 patients with FIGO stage II disease received adjuvant chemotherapy consisting of cisplatin and etoposide (or cyclophosphamide) or combined chemoradiation. The 5-year disease-free survival rate for these patients was 87.5%, a value significantly higher than for patients that received radiation therapy alone (30%). Conclusion: Adjuvant chemotherapy or combination chemo-radiotherapy might be superior to radiation therapy alone in high-risk early endometrial cancer patients.

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Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: A gynecologic oncology group study

Cited by 1,190 publications

References 8 publications

The Reproducibility of a Binary Tumor Grading System for Uterine Endometrial Endometrioid Carcinoma, Compared with FIGO System and Nuclear Grading

The Reproducibility of a Binary Tumor Grading System for Uterine Endometrial Endometrioid Carcinoma, Compared with FIGO System and Nuclear Grading

Is Peritoneal Cytology a Prognostic Factor in Endometrial Cancer?

Adjuvant therapy in high-risk early endometrial carcinoma: a retrospective analysis of 46 cases

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