Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

Güngördük, Kemal; Cüylan, Zeliha Fırat; Kahramanoğlu, İlker; Öge, Tufan; Akbayır, Özgür; Dede, Murat; Taşkın, Salih; Özgül, Nejat; Şimşek, Tayup; Turan, Hasan; Gülseren, Varol; Ozdemir, Aykut; Meydanlı, Mehmet Mutlu; Ayhan, Ali

doi:10.1159/000488112

Cited by 18 publications

(20 citation statements)

References 22 publications

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“…LVSI is another well-documented prognostic factor in endometrial cancer. Patients with LVSI have 5.8 times the increased risk of recurrence ( 34 ). Guntupalli et al ( 13 ) showed that LVSI had a 95% negative predictive value for nodal disease.…”

Section: Discussionmentioning

confidence: 99%

Binary grading may be more appropriate for endometrial cancer

Koyuncu

Altın

Turgay

et al. 2020

J Turkish German Gynecol Assoc

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Objective: To elucidate the survival consequences of the prognostic factors for endometrial cancer. Material and Methods: This was a retrospective study of 276 patients diagnosed with endometrial cancer who admitted for staging surgery. The extent of the surgery was determined by clinical staging and preoperative evaluation. The pathology specimens were reassessed by a gynecopathologist. Independent risk factors were revealed for the progression-free survival (PFS), overall survival (OS) and disease-specific survival (DSS) utilizing Kaplan-Meier and “Cox” proportional analysis. Results: The median follow up of the patients was 50 months. Of the 29 patients who died, 15 (5.43%) died because of endometrial cancer. Multivariate analysis revealed that independent risk factors for OS and PFS were stage (p=0.002, 0.002, respectively) and grade 3 (G3) histology (p=0.013, 0.015, respectively). Positive peritoneal cytology was an independent risk factor for OS (p=0.024), but not for PFS (p=0.050). Stage (p=0.005) was found to be the only independent risk factor for DSS. Patients with G1 and G2 histology had a similar and more favorable prognosis than patients with G3 histology. Conclusion: Advanced stage, high-grade tumor and the presence of positive peritoneal cytology were ascertained as independent prognostic factors for endometrial cancer. A binary histological grading system could be simpler and as effective as the current three grade system because grade 1 and 2 patients showed similar prognosis.

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Section: Discussionmentioning

confidence: 99%

Binary grading may be more appropriate for endometrial cancer

Koyuncu

Altın

Turgay

et al. 2020

J Turkish German Gynecol Assoc

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“…In current study, 58 patients (50%) had accompanying metabolic disease so significant percent of our patients were not having excellent health status. Unfortunately, adjuvant treatment of the endometrial cancer is not powered by the phase studies, therefore decision was made case by case 12 . In our study, there is very low rate of systemic relapse and one patient died during platin based adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of early stage endometrial cancer patients: single center experience

Sedef

Karaduman

Beşen

et al. 2019

Cukurova Medical Journal

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The aim of this study was to evaluate clinicopathological characteristics and treatment outcomes of early stages endometrial cancer patients in our center. Materials and Methods: This study was a hospital-based retrospective observational case-series study. 116 patients were included in the study from Baskent University Department of Medical Oncology and Gynecological Oncology between the years of 2009-2015. De-novo metastatic patients were not included in the study. Results: The median age of the patients was 58 (range 27-81) years. All of patients had European Cooperative Oncology Group (ECOG) performance score 0 (n:116). Endometrioid histology was the most common histopathological subtype (n:103, 88%). All of the patients were in local and local advanced stage. The significant percentage of patients had grade 2 tumor (n:55, 47.4%). Myometrial invasion was less than 50% in 78 patients (67.2 %). The median follow-up time was 61 months and 8 (6.9%) patients died. All patients underwent standard surgical staging with standard lymphadenectomy. Overall survival (OS) was not reached. There were 14 patients (12.1 %) and 34 patients (29.3 %) treated with adjuvant chemotherapy and radiotherapy, respectively. Conclusion: Though endometrial cancer is the most common gynecological tumors in women, cure rate is very high. Relapse rate was 6 % (7 patients) and most of the relapse were local, 71.4% (5 patients).

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“…The prognostic factors, including the patients' clinical characteristics, surgical procedures, pathological features, adjuvant treatments, genetic alterations, and hematological parameters, which are predictors for cancer-related inflammation, have been studied in many EC reports [14][15][16][17][18][19][20][21]. Nevertheless, most of the analyses included heterogeneous groups of patients whose diseases had different stages or risk groups.…”

Section: Introductionmentioning

confidence: 99%

The Ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer

Çubukçu¹,

Şahin²,

Atalay³

et al. 2021

EJGO

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To investigate the prognostic factors comparing clinical, histopathological, and laboratory parameters in low-risk endometrial cancer (EC). Methods: In the present single-center study, multivariate Cox regression analysis was performed on retrospective clinical and laboratory data and histopathological features obtained from the re-evaluation of 253 patients with low-risk EC. Receiver operating characteristic curves (ROC) were plotted for neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio, lymphocyte-monocyte ratio and Ki-67 index for recurrence. Kaplan-Meier analysis was employed for survival rates. Results: The median age was 58.5 years (32.0-75.4). Most of the patients were obese and post-menopausal. In nearly half of the patients, lymphadenectomy was performed in addition to hysterectomy and oophorectomy. The median tumor size was 30 mm (range 2-80), and the median Ki-67 index was 25 (1-90). According to the ROC curve analysis, the cut-off values for the Ki-67 index, NLR, PLR, and LMR were determined as ≥22, ≥1.98, ≥115.3, and ≤4.71, respectively. The log-rank test revealed that the patients with a Ki-67 index lower than 22% and NLR lower than 1.98 had statistically longer recurrence-free survival (RFS) (p = 0.002 for Ki-67 index and p = 0.004 for NLR). The multivariate analysis revealed that the Ki-67 index and NLR were statistically significant factors for RFS (p = 0.012 and p = 0.029, respectively). Conclusion: The present study highlights the prognostic implications of both the Ki-67 index and NLR in lowrisk EC.

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Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

Cited by 18 publications

References 22 publications

Binary grading may be more appropriate for endometrial cancer

Binary grading may be more appropriate for endometrial cancer

Treatment outcomes of early stage endometrial cancer patients: single center experience

The Ki-67 index and neutrophile-lymphocyte ratio are prognostic factors in patients with low-risk endometrial cancer

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