OBJECTIVE: Overall survival (OS) in endometrial cancer (EC) is dependent on patient-, disease-, and treatment-specific risk factors. Comprehensive risk-scoring models were developed to estimate OS in low-grade and high-grade EC. METHODS: Patients undergoing primary surgery for EC from 1999 through 2008 were stratified histologically according to the International Federation of Gynecology and Obstetrics (FIGO) as either (i) low grade: grades 1 and 2 endometrioid EC or (ii) high grade: grade 3, including non-endometrioid EC. Associations between patient-, pathological-, and treatment-specific risk factors and OS starting on postoperative day 30 were assessed using multivariable Cox regression models. Factors independently associated with OS were used to construct nomograms and risk-scoring models. RESULTS: Eligible patients (N=1281) included 925 low-grade and 356 high-grade patients; estimated 5-year OSs were 87.0% and 51.5%, respectively. Among patients alive at last follow-up, median follow-up was 5.0 (low grade) and 4.6years (high grade), respectively. In low-grade patients, independent factors predictive of compromised OS included age, cardiovascular disease, pulmonary dysfunction, stage, tumor diameter, pelvic lymph node status, and grade 2 or higher 30-day postoperative complications. Among high-grade patients, age, American Society of Anesthesiologists score, stage, lymphovascular space invasion, adjuvant therapy, para-aortic nodal status, and cervical stromal invasion were independent predictors of compromised OS. The two risk-scoring models/nomograms had excellent calibration and discrimination (unbiased c-indices=0.803 and 0.759). CONCLUSION: Patients with low-grade and high-grade EC can be counseled regarding their predicted OS using the proposed risk-scoring models. This may facilitate institution of personalized treatment algorithms, surveillance strategies, and lifestyle interventions.
OBJECTIVE: Overall survival (OS) in endometrial cancer (EC) is dependent on patient-, disease-, and treatment-specific risk factors. Comprehensive risk-scoring models were developed to estimate OS in low-grade and high-grade EC. METHODS:Patients undergoing primary surgery for EC from 1999 through 2008 were stratified histologically according to the International Federation of Gynecology and Obstetrics (FIGO) as either (i) low grade: grades 1 and 2 endometrioid EC or (ii) high grade: grade 3, including non-endometrioid EC. Associations between patient-, pathological-, and treatment-specific risk factors and OS starting on postoperative day 30 were assessed using multivariable Cox regression models. Factors independently associated with OS were used to construct nomograms and risk-scoring models. RESULTS: Eligible patients (N=1281) included 925 low-grade and 356 high-grade patients; estimated 5-year OSs were 87.0% and 51.5%, respectively. Among patients alive at last follow-up, median follow-up was 5.0 (low grade) and 4.6years (high grade), respectively. In low-grade patients, independent factors predictive of compromised OS included age, cardiovascular disease, pulmonary dysfunction, stage, tumor diameter, pelvic lymph node status, and grade 2 or higher 30-day postoperative complications. Among high-grade patients, age, American Society of Anesthesiologists score, stage, lymphovascular space invasion, adjuvant therapy, para-aortic nodal status, and cervical stromal invasion were independent predictors of compromised OS. The two risk-scoring models/nomograms had excellent calibration and discrimination (unbiased c-indices=0.803 and 0.759). CONCLUSION:Patients with low-grade and high-grade EC can be counseled regarding their predicted OS using the proposed risk-scoring models. This may facilitate institution of personalized treatment algorithms, surveillance strategies, and lifestyle interventions.
Authors: W T Creasman; F Odicino; P Maisonneuve; M A Quinn; U Beller; J L Benedet; A P M Heintz; H Y S Ngan; S Pecorelli Journal: Int J Gynaecol Obstet Date: 2006-11 Impact factor: 3.561
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Authors: Ashley S Felix; D Scott McMeekin; David Mutch; Joan L Walker; William T Creasman; David E Cohn; Shamshad Ali; Richard G Moore; Levi S Downs; Olga B Ioffe; Kay J Park; Mark E Sherman; Louise A Brinton Journal: Gynecol Oncol Date: 2015-09-01 Impact factor: 5.482
Authors: A Talhouk; M K McConechy; S Leung; H H Li-Chang; J S Kwon; N Melnyk; W Yang; J Senz; N Boyd; A N Karnezis; D G Huntsman; C B Gilks; J N McAlpine Journal: Br J Cancer Date: 2015-06-30 Impact factor: 7.640
Authors: Mee Sun Yoon; Seung Jae Huh; Hak Jae Kim; Young Seok Kim; Yong Bae Kim; Joo-Young Kim; Jong-Hoon Lee; Hun Jung Kim; Jihye Cha; Jin Hee Kim; Juree Kim; Won Sup Yoon; Jin Hwa Choi; Mison Chun; Youngmin Choi; Kang Kyoo Lee; Myungsoo Kim; Jae-Uk Jeong; Sei Kyung Chang; Won Park Journal: Cancer Res Treat Date: 2015-10-29 Impact factor: 4.679
Authors: Ashley S Felix; Louise A Brinton; D Scott McMeekin; William T Creasman; David Mutch; David E Cohn; Joan L Walker; Richard G Moore; Levi S Downs; Robert A Soslow; Richard Zaino; Mark E Sherman Journal: J Natl Cancer Inst Date: 2015-06-18 Impact factor: 13.506