Koji Matsuo1, Shinya Matsuzaki2, David J Nusbaum2, Hiroko Machida3, Yoshikazu Nagase4, Brendan H Grubbs5, Lynda D Roman6, Jason D Wright7, Philipp Harter8, Maximilian Klar9. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. Electronic address: koji.matsuo@med.usc.edu. 2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA. 3. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan. 4. Department of Obstetrics and Gynecology, Osaka University School of Medicine, Osaka, Japan. 5. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA. 6. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. 7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA. 8. Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany. 9. Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany.
Abstract
BACKGROUND: To examine the association between malignant peritoneal cytology and survival in women with early-stage endometrioid endometrial cancer. METHODS: This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program from 2010 to 2016. Women with stage I endometrioid endometrial cancer who had peritoneal cytology testing at hysterectomy were examined (N = 24,800). Characteristics and survival related to malignant peritoneal cytology were assessed. The propensity score inverse probability of treatment weighting was used to balance the measured covariates. FINDINGS: Malignant peritoneal cytology was reported in 1081 (4.4%) women. In multivariable analysis, stage IB disease and moderately/poorly differentiated tumours were associated with an increased likelihood of malignant peritoneal cytology (both P < 0.05). In a weighted model, malignant peritoneal cytology was associated with decreased cause-specific survival (5-year rates, 92.1% versus 96.8%, hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.56-2.52) and overall survival (89.4% versus 93.1%, HR 1.41, 95% CI 1.16-1.72). In sensitivity analyses, malignant peritoneal cytology was associated with decreased overall survival in the high-intermediate-risk group (5-year rates, 77.8% versus 83.6%, HR 1.57, 95% CI 1.20-2.06) and decreased cause-specific survival in the low-risk group (95.4% versus 98.0%, HR 1.64, 95% CI 1.01-2.68). In the high-intermediate-risk group with malignant peritoneal cytology, postoperative chemotherapy was associated with improved overall survival compared to whole pelvic radiotherapy (5-year rates, 82.7% versus 64.6%, HR 0.36, 95% CI 0.14-0.96). This association was not observed in negative cytology cases (81.5% versus 79.7%, HR 0.78, 95% CI 0.53-1.14). INTERPRETATION: Malignant peritoneal cytology may be associated with decreased survival in stage I endometrioid endometrial cancer.
BACKGROUND: To examine the association between malignant peritoneal cytology and survival in women with early-stage endometrioid endometrial cancer. METHODS: This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program from 2010 to 2016. Women with stage I endometrioid endometrial cancer who had peritoneal cytology testing at hysterectomy were examined (N = 24,800). Characteristics and survival related to malignant peritoneal cytology were assessed. The propensity score inverse probability of treatment weighting was used to balance the measured covariates. FINDINGS: Malignant peritoneal cytology was reported in 1081 (4.4%) women. In multivariable analysis, stage IB disease and moderately/poorly differentiated tumours were associated with an increased likelihood of malignant peritoneal cytology (both P < 0.05). In a weighted model, malignant peritoneal cytology was associated with decreased cause-specific survival (5-year rates, 92.1% versus 96.8%, hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.56-2.52) and overall survival (89.4% versus 93.1%, HR 1.41, 95% CI 1.16-1.72). In sensitivity analyses, malignant peritoneal cytology was associated with decreased overall survival in the high-intermediate-risk group (5-year rates, 77.8% versus 83.6%, HR 1.57, 95% CI 1.20-2.06) and decreased cause-specific survival in the low-risk group (95.4% versus 98.0%, HR 1.64, 95% CI 1.01-2.68). In the high-intermediate-risk group with malignant peritoneal cytology, postoperative chemotherapy was associated with improved overall survival compared to whole pelvic radiotherapy (5-year rates, 82.7% versus 64.6%, HR 0.36, 95% CI 0.14-0.96). This association was not observed in negative cytology cases (81.5% versus 79.7%, HR 0.78, 95% CI 0.53-1.14). INTERPRETATION: Malignant peritoneal cytology may be associated with decreased survival in stage I endometrioid endometrial cancer.
Authors: Nikolaos P Polyzos; Davide Mauri; Spyridon Tsioras; Christina I Messini; Antonis Valachis; Ioannis E Messinis Journal: Int J Gynecol Cancer Date: 2010-02 Impact factor: 3.437
Authors: Gunjal Garg; Feng Gao; Jason D Wright; Andrea R Hagemann; David G Mutch; Matthew A Powell Journal: Gynecol Oncol Date: 2012-09-29 Impact factor: 5.482
Authors: Stephanie M de Boer; Melanie E Powell; Linda Mileshkin; Dionyssios Katsaros; Paul Bessette; Christine Haie-Meder; Petronella B Ottevanger; Jonathan A Ledermann; Pearly Khaw; Romerai D'Amico; Anthony Fyles; Marie-Helene Baron; Ina M Jürgenliemk-Schulz; Henry C Kitchener; Hans W Nijman; Godfrey Wilson; Susan Brooks; Sergio Gribaudo; Diane Provencher; Chantal Hanzen; Roy F Kruitwagen; Vincent T H B M Smit; Naveena Singh; Viet Do; Andrea Lissoni; Remi A Nout; Amanda Feeney; Karen W Verhoeven-Adema; Hein Putter; Carien L Creutzberg Journal: Lancet Oncol Date: 2019-07-22 Impact factor: 41.316
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
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
Authors: Koji Matsuo; Hilary Novatt; Shinya Matsuzaki; Marianne S Hom; Antonio V Castaneda; Ernesto Licon; David J Nusbaum; Lynda D Roman Journal: Gynecol Oncol Date: 2020-05-18 Impact factor: 5.482