Analysis of risk factors for recurrence and effective adjuvant therapy in patients with endometrial cancer

2002 ◽  
Vol 28 (2) ◽  
pp. 112-114
Author(s):  
Tomoko Goto ◽  
Masayoshi Takano ◽  
Tsunekazu Kita ◽  
Yoshihiro Kikuchi
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Adjuvant Therapy ◽  
Risk Factors For Recurrence

Risk Factors for Recurrence in Low-Risk Endometrial Cancer: A Case-Control Study

2018 ◽  
Vol 41 (7-8) ◽  
pp. 466-470 ◽  
Author(s):  
Kemal Güngördük ◽  
Zeliha Firat Cüylan ◽  
Ilker Kahramanoglu ◽  
Tufan Oge ◽  
Ozgur Akbayir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Case Control Study ◽  
Case Control ◽  
Low Risk ◽  
Risk Factors For Recurrence ◽  
Control Study

scholarly journals Insulin Resistance and Metabolic Syndrome Increase the Risk of Relapse For Fertility Preserving Treatment in Atypical Endometrial Hyperplasia and Early Endometrial Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Xingchen Li ◽  
Yuan Fan ◽  
Jiaqi Wang ◽  
Rong Zhou ◽  
Li Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Univariate Analysis ◽  
Roc Curves ◽  
Atypical Endometrial Hyperplasia ◽  
Fertility Sparing ◽  
Risk Factors For Recurrence

ObjectiveFertility-sparing treatment for young women with atypical endometrial hyperplasia (AEH) and early endometrial cancer (EC) is a difficult challenge. Insulin resistance (IR) and metabolic syndrome (MetS) are two potentially crucial, but currently enigmatic factors in the recurrence of AEH and early EC patients. In this study we attempt to elucidate these factors.MethodsA retrospective study was conducted from January 2010 to December 2019. Risk factors for recurrence and complete remission time after recurrence (RCR time) were investigated. ROC curves were built to estimate the accuracy of the metabolic characteristics and Kaplan–Meier (K–M) analysis was used to calculate recurrence-free survival (RFS) for patients with various IR or MetS statuses.ResultsA total of 111 AEH or early EC patients met the criteria and were enrolled in our study. Univariate analysis found that BMI ≥25 kg/m2 (OR = 2.7, 95% CI: 1.1–6.4, P = 0.03), IR (OR = 9.5, 95% CI: 3.3–27.0, P <0.001), MetS (OR = 4.9, 95% CI:1.5–15.5, P = 0.008), IR+ and MetS+ (OR = 21.0, 95% CI: 4.8–92.7, P <0.001), histological type (OR = 3.5, 95% CI: 1.5–7.9, P = 0.003), and maintenance treatment (OR = 0.3, 95% CI: 0.1–0.6, P = 0.005) were all significantly associated with recurrence and longer RCR time. Among these factors, IR and MetS were determined to be two independent risk factors for recurrence. Moreover, using IR and MetS as markers significantly improved the diagnostic accuracy of recurrence for fertility-sparing treatment patients (AUC = 0.818, P <0.05) and may play synergistic roles in suppressing treatment. K–M analysis indicated both metabolic features played important roles in RFS (P <0.05).ConclusionBoth IR and MetS were significantly associated with recurrence and longer RCR time in AEH and early EC patients receiving fertility-sparing treatment.

scholarly journals Controversies in the Adjuvant Therapy of Endometrial Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Sheng-Mou Hsiao ◽  
Lin-Hung Wei
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Randomized Trials ◽  
Female Genital Tract ◽  
Myometrial Invasion ◽  
Cell Types ◽  
High Risk Factors ◽  
Grade 3

Endometrial cancer is the most common malignancy of the female genital tract. Surgical treatment includes hysterectomy, bilateral salpingo-oophorectomy, and an appropriate staging procedure. Relapse of endometrial cancer may occur in patients with high risk factors, such as old age, grade 3 cancer, deep myometrial invasion, and papillary serous and clear cell types. In recent years, several randomized trials reported the results of adjuvant therapy for patients with high risk factors. Nonetheless, some controversies still exist. This paper presents and discusses the results of important randomized trials of adjuvant therapy for endometrial cancer with risk factors.

Abnormal cervical cytology: a risk factor for endometrial cancer recurrence

2005 ◽  
Vol 15 (3) ◽  
pp. 517-522 ◽  
Author(s):  
A. K. Brown ◽  
S. Gillis ◽  
C. Deuel ◽  
C. Angel ◽  
C. Glantz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Endometrial Cancer ◽  
High Risk ◽  
Cancer Recurrence ◽  
Myometrial Invasion ◽  
Nodal Status ◽  
Cervical Cytology ◽  
Abnormal Cervical Cytology ◽  
Risk Factors For Recurrence

The objective of this study was to evaluate the relationship between cervical cytology, histologic type, and risk of endometrial cancer recurrence. We performed a retrospective study of patients undergoing surgery for endometrial carcinoma. Risk factors for recurrence including histology, tumor grade, nodal status, myometrial invasion, peritoneal washings, stage, and cervical cytology were assessed. Abnormal cervical cytology was defined as the presence of any endometrial cells on Pap smear. Papillary serous and clear cell carcinomas were considered high-risk histologies. Univariate and multivariate analyses of risk factors for recurrence were performed. Thirty-nine (9%) patients developed recurrent endometrial cancer. More patients with abnormal Pap smears recurred (12% versus 4%, P < 0.05). For endometrioid adenocarcinoma, abnormal cervical cytology occurred in 61% and 7% recurred, while with high-risk histologies, 84% had abnormal cervical cytology and 19% recurred (P < 0.05). Other significant predictors of recurrence on univariate analysis were myometrial invasion, nodal status, washings, stage, and histology. On multivariate analysis, only nodal status remained a significant predictor of recurrence. Abnormal cervical cytology is associated with increased risk of endometrial cancer recurrence. Abnormal cervical cytology occurs more frequently in high-risk histologies, which are known to have a higher risk of recurrence. On multivariate analysis, only nodal spread remains a significant predictor of recurrence.

A randomized phase-III study on adjuvant treatment with radiation (RT) ± chemotherapy (CT) in early-stage high-risk endometrial cancer (NSGO-EC-9501/EORTC 55991)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5503-5503 ◽  
Author(s):  
T. Hogberg ◽  
P. Rosenberg ◽  
G. Kristensen ◽  
C. F. de Oliveira ◽  
R. de Pont Christensen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Phase Iii ◽  
Absolute Difference ◽  
Carboplatin Auc ◽  
Better Than

5503 Background: Adjuvant therapy for early stage high-risk endometrial cancer remains controversial. Methods: Patients with surgical stage I, II, IIIA (positive peritoneal fluid cytology only), or IIIC (positive pelvic lymph nodes only) were eligible if they, according to departmental guidelines, had a sufficiently high risk for micrometastatic disease to qualify for adjuvant therapy. Most patients had two or more of the risk factors: grade 3, deep myometrial invasion, or DNA non-diploidy, while some patients had only one of these. Patients with serous, clear cell, or anaplastic carcinomas were eligible regardless of risk factors. Patients with para-aortic metastases were not eligible. Lymph node exploration at staging surgery was optional. Pelvic RT ± vaginal brachytherapy was given to a dose =44 Gy. CT was given before or after RT. Before August 2004 CT consisted of four courses of cisplatin =50 mg/m2 + doxorubicin 50 mg/m2 or epirubicin 75 mg/m2 (AP). Thereafter several CT regimens were allowed, of which AP, paclitaxel 175 mg/m2 + epirubicin 60 mg/m2 + carboplatin AUC 5, and paclitaxel 175 mg/m2 + carboplatin AUC 5–6 were used. Progression-free survival (PFS) was the primary end-point. The study was terminated before the aimed goal of 400 patients because of slow recruitment. We decided to make an early analysis since new studies on endometrial cancer are presently discussed. Results: 372 patients were entered between May 1996 and Oct 2006. Of 367 evaluable patients 190 were randomized to RT and 177 to RT+CT. Risk factors were well balanced between the randomization arms. The median follow-up time was 3.5 years. The hazard ratio for PFS was 0.58 in favor of RT+CT (95 % confidence interval (CI) 0.34 - 0.99; p=0.046). This translates to an estimated 7 % absolute difference in 5-year PFS from 75 % (95 % CI 67 % - 82 %) to 82 % (95 % CI 73 % - 88 %). Conclusion: RT+CT was better than RT alone. Next question is if RT+CT is better than CT alone. No significant financial relationships to disclose.

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