Quantification of Recurrence Risk Based on Number of Adverse Prognostic Factors in Women with Early Stage Uterine Endometrioid Carcinoma
Elshaikh MA, Aref I, Ghanem AI, Khalil R, Burmeister C, and Hanna RK. Quantification of Recurrence Risk Based on Number of Adverse Prognostic Factors in Women with Early Stage Uterine Endometrioid Carcinoma. International Journal of Radiation Oncology Biology Physics 2020; 108(3):e499-e500.
International Journal of Radiation Oncology Biology Physics
Purpose/Objective(s): We sought to quantify the risk of recurrence in women with International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial carcinoma, solely of endometrioid based on the number of adverse prognostic factors.
Materials/Methods: We identified 1133 women at our institution who underwent a hysterectomy and did not receive any adjuvant therapy between 1/1990 and 12/2019. Cox proportional hazards model was used to identify independent predictors of recurrence. Prognostic groups were created based on the number of independent predictors of recurrence (0, 1 or 2 or 3 risk factors).
Results: Median follow-up was 84 months. Independent prognostic factors of recurrence included age ≥ 60, grade 2/3 and the presence of lymphovascular space invasion (LVSI). Due to small number in groups with 2 or 3 risk factors, these were combined into one group (group 2). Isolated vaginal cuff recurrence was the most common site of recurrence in the study groups (81%, 58% and 70% for groups 0, 1 and 2, respectively). Five-year recurrence rates were 4%, 15%, and 43% for groups 0, 1, and 2 (p<0.001), respectively. Five-year disease-specific survival were 99%, 96% and 85% and 5-year overall survival were 94%, 85% and 63% (p<0.001), respectively.
Conclusion: On the basis of 3 well-known prognostic factors, individualized recurrence rate can be predicted in women with stage I endometrial carcinoma. This simplified predictive tool may be helpful in estimating individualized risk of recurrence and guide counseling with regard to adjuvant treatment.