Recurrence Risk Stratification for Women With FIGO Stage I Uterine Endometrioid Carcinoma Who Underwent Surgical Lymph Node Evaluation.

Document Type

Article

Publication Date

12-1-2023

Publication Title

American journal of clinical oncology

Abstract

OBJECTIVE: The aim of this study was to estimate the recurrence risk based on the number of prognostic factors for patients with stage I uterine endometrioid carcinoma (EC) who underwent surgical lymph node evaluation (SLNE) and were managed with observation.

METHODS: We queried our database for women with FIGO-2009 stage I EC who underwent surgical staging including SLNE. Multivariate analysis with stepwise model selection was used to determine independent risk factors for 5-year recurrence-free survival (RFS). Study groups based on risk factors were compared for RFS, disease-specific survival, and overall survival.

RESULTS: A total of 706 patients were identified: median age was 60 years (range, 30 to 93 y) and median follow-up was 120 months. Median number of examined lymph nodes was 8 (range, 1 to 66). 91% were stage IA, 75% had grade 1 and lymphovascular space invasion was detected in 6%. Independent predictors of 5-year RFS included age 60 years and above (P=0.038), grade 2 (P=0.003), and grade 3 (P<0.001) versus grade 1. Five-year RFS for group 0 (age less than 60 y and grade 1) was 98% versus 92% for group 1 (either: age 60 y and older or grade 2/3) versus 84% for group 2 (both: age 60 y and above and grade 2/3), respectively (P<0.001). Five-year disease-specific survival was 100% versus 98% versus 95%, (P=0.012) and 5-year overall survival was 98% versus 90% versus 81%, for groups 0, 1, and 2, respectively (P<0.001).

CONCLUSIONS: In patients with stage I EC who received SLNE and no adjuvant therapy, only age 60 years and above and high tumor grade were independent predictors of recurrence and can be used to quantify individualized recurrence risk, whereas lymphovascular space invasion was not an independent prognostic factor in this cohort.

Medical Subject Headings

Humans; Female; Middle Aged; Prognosis; Carcinoma, Endometrioid; Neoplasm Staging; Retrospective Studies; Hysterectomy; Endometrial Neoplasms; Lymph Nodes; Lymph Node Excision; Risk Assessment; Neoplasm Recurrence, Local

PubMed ID

37679878

ePublication

ePub ahead of print

Volume

46

Issue

12

First Page

537

Last Page

542

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