Geoffroy Canlorbe1,2,3, Sofiane Bendifallah4,5,6, Enora Laas4,5, Emilie Raimond7, Olivier Graesslin7, Delphine Hudry8, Charles Coutant8, Cyril Touboul9, Géraldine Bleu10, Pierre Collinet10, Annie Cortez11, Emile Daraï4,5,12, Marcos Ballester4,5,12. 1. Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France. geoffroy.canlorbe@tnn.aphp.fr. 2. Institut Universitaire de Cancérologie (IUC), University Pierre and Marie Curie, Paris, France. geoffroy.canlorbe@tnn.aphp.fr. 3. Saint Antoine Research Center, U938, Institut National de la Santé et de la Recherche Médicale (INSERM), University Pierre et Marie Curie-Paris VI, Paris, France. geoffroy.canlorbe@tnn.aphp.fr. 4. Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France. 5. Institut Universitaire de Cancérologie (IUC), University Pierre and Marie Curie, Paris, France. 6. INSERM UMR S 707, Epidemiology, Information Systems, Modeling, University Pierre and Marie Curie, Paris, France. 7. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France. 8. Centre de lutte contre le cancer Georges François Leclerc, Dijon, France. 9. Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France. 10. Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France. 11. Department of Pathology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France. 12. Saint Antoine Research Center, U938, Institut National de la Santé et de la Recherche Médicale (INSERM), University Pierre et Marie Curie-Paris VI, Paris, France.
Abstract
BACKGROUND: Additional tools are needed to improve the selection of women with early-stage endometrial cancer (EC) at increased risk of nodal metastases and/or recurrence to adapt surgical staging and adjuvant therapies. The aim of this study was to assess the impact of EC tumor size on nodal status and recurrence-free survival (RFS) according to European risk groups for recurrence. METHODS: Data of 633 women with early-stage EC who received primary surgical treatment between 2001 and 2012 were abstracted from a multicenter database. Optimal tumor size cut-offs were determined by a minimal p value approach according to final nodal status. Logistic regression was used to determine the impact of defined tumor size on nodal involvement, and the Kaplan-Meier method was used to estimate the survival distribution. RESULTS: The number of women with final low-, intermediate-, and high-risk EC was 302, 204, and 127, respectively. Tumor size was correlated with nodal status and RFS in women with low-risk EC, while no correlation was found for women with intermediate/high-risk EC. Tumor size ≥35 mm emerged as the optimal threshold for a higher rate of nodal involvement (odds ratio 4.318, 95 % CI 1.13-16.51, p = 0.03) and a lower RFS (p = 0.005) in women with low-risk EC. CONCLUSION: Tumor size is an independent prognostic factor of lymph node involvement in women with low-risk EC and could be a valuable additional histological criterion for selecting women at increased risk of lymph node metastases to better adapt surgical staging.
BACKGROUND: Additional tools are needed to improve the selection of women with early-stage endometrial cancer (EC) at increased risk of nodalmetastases and/or recurrence to adapt surgical staging and adjuvant therapies. The aim of this study was to assess the impact of EC tumor size on nodal status and recurrence-free survival (RFS) according to European risk groups for recurrence. METHODS: Data of 633 women with early-stage EC who received primary surgical treatment between 2001 and 2012 were abstracted from a multicenter database. Optimal tumor size cut-offs were determined by a minimal p value approach according to final nodal status. Logistic regression was used to determine the impact of defined tumor size on nodal involvement, and the Kaplan-Meier method was used to estimate the survival distribution. RESULTS: The number of women with final low-, intermediate-, and high-risk EC was 302, 204, and 127, respectively. Tumor size was correlated with nodal status and RFS in women with low-risk EC, while no correlation was found for women with intermediate/high-risk EC. Tumor size ≥35 mm emerged as the optimal threshold for a higher rate of nodal involvement (odds ratio 4.318, 95 % CI 1.13-16.51, p = 0.03) and a lower RFS (p = 0.005) in women with low-risk EC. CONCLUSION:Tumor size is an independent prognostic factor of lymph node involvement in women with low-risk EC and could be a valuable additional histological criterion for selecting women at increased risk of lymph node metastases to better adapt surgical staging.
Authors: Matthew M Harkenrider; Alec M Block; Kaled M Alektiar; David K Gaffney; Ellen Jones; Ann Klopp; Akila N Viswanathan; William Small Journal: Brachytherapy Date: 2016-05-31 Impact factor: 2.362
Authors: Paweł Cisek; Dariusz Kieszko; Izabela Kordzińska-Cisek; Elżbieta Kutarska; Ludmiła Grzybowska-Szatkowska Journal: Biomed Res Int Date: 2018-02-21 Impact factor: 3.411