S A Scott1, C van der Zanden2, E Cai3, C E McGahan4, J S Kwon5. 1. Dalhousie University, Canada. Electronic address: StephanieA.Scott@nshealth.ca. 2. Radboud University, Netherlands. 3. Cancer Surveillance & Outcomes, BC Cancer Agency, Canada. 4. Cancer Surveillance & Outcomes, BC Cancer Agency, Canada; Surgical Oncology Network, BC Cancer Agency, Canada. 5. BC Cancer Agency, Canada; University of British Columbia, Canada.
Abstract
OBJECTIVES: There is uncertainty surrounding the prognostic value and clinical utility of peritoneal cytology in endometrial cancer. Our primary objective was to determine if positive cytology is associated with disease-free and overall survival in women treated surgically for endometrial cancer, specifically those with low or intermediate risk disease. METHODS: This was a retrospective population-based cohort study of British Columbia Cancer Registry patients who underwent surgery with peritoneal washings for endometrioid-type endometrial cancer from 2003 to 2009. Low risk was defined as Stage IA grade 1 or 2, and intermediate risk defined as Stage IA grade 3, or Stage IB grade 1 or 2 tumours. Five-year overall and disease free-survival were assessed using Kaplan-Meier estimation. Potential covariates including peritoneal cytology, grade, depth of myometrial invasion, LVSI, age, and adjuvant therapy were evaluated in a multivariable Cox proportional hazards model. RESULTS: There were 849 patients, of whom 370 (43.6%) and 298 (35.1%) had low- and intermediate-risk disease, respectively. Overall, forty-nine (5.8%) patients had positive cytology, including 6 and 9 with low- and intermediate-risk respectively (2.2% within low and intermediate risk combined). Positive peritoneal cytology was not significantly associated with disease-free (HR 3.17, 95% CI 0.91-11.03) or overall survival (HR 1.33, 95% CI 0.47-3.76) in low and intermediate risk patients. Only age and extensive LVSI were associated with lower overall survival (HR 1.10, 95% CI 1.08-1.13, and HR 2.39, 95% CI 1.02-5.61, respectively). CONCLUSIONS: Positive peritoneal cytology was not associated with disease-free and overall survival in women with low and intermediate risk endometrial cancer.
OBJECTIVES: There is uncertainty surrounding the prognostic value and clinical utility of peritoneal cytology in endometrial cancer. Our primary objective was to determine if positive cytology is associated with disease-free and overall survival in women treated surgically for endometrial cancer, specifically those with low or intermediate risk disease. METHODS: This was a retrospective population-based cohort study of British Columbia Cancer Registry patients who underwent surgery with peritoneal washings for endometrioid-type endometrial cancer from 2003 to 2009. Low risk was defined as Stage IA grade 1 or 2, and intermediate risk defined as Stage IA grade 3, or Stage IB grade 1 or 2 tumours. Five-year overall and disease free-survival were assessed using Kaplan-Meier estimation. Potential covariates including peritoneal cytology, grade, depth of myometrial invasion, LVSI, age, and adjuvant therapy were evaluated in a multivariable Cox proportional hazards model. RESULTS: There were 849 patients, of whom 370 (43.6%) and 298 (35.1%) had low- and intermediate-risk disease, respectively. Overall, forty-nine (5.8%) patients had positive cytology, including 6 and 9 with low- and intermediate-risk respectively (2.2% within low and intermediate risk combined). Positive peritoneal cytology was not significantly associated with disease-free (HR 3.17, 95% CI 0.91-11.03) or overall survival (HR 1.33, 95% CI 0.47-3.76) in low and intermediate risk patients. Only age and extensive LVSI were associated with lower overall survival (HR 1.10, 95% CI 1.08-1.13, and HR 2.39, 95% CI 1.02-5.61, respectively). CONCLUSIONS: Positive peritoneal cytology was not associated with disease-free and overall survival in women with low and intermediate risk endometrial cancer.
Authors: Koji Matsuo; Shinya Matsuzaki; David J Nusbaum; Hiroko Machida; Yoshikazu Nagase; Brendan H Grubbs; Lynda D Roman; Jason D Wright; Philipp Harter; Maximilian Klar Journal: Eur J Cancer Date: 2020-05-17 Impact factor: 9.162
Authors: Koji Matsuo; David J Nusbaum; Shinya Matsuzaki; Erica J Chang; Lynda D Roman; Jason D Wright; Philipp Harter; Maximilian Klar Journal: Gynecol Oncol Date: 2020-07-18 Impact factor: 5.482