Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Eur J Surg Oncol. 2010 Dec;36(12):1195-201. doi: 10.1016/j.ejso.2010.09.010.
To explore and to compare the outcome of patients diagnosed with stage II/III/IV and stage III/IV endometrioid adenocarcinoma (EAC) with their serous carcinoma (USC) counterparts.
A total of 107 patients (73 EAC and 34 USC) were evaluated. For statistical analysis, the following baseline variables were considered for their prognostic value: the patient's age at presentation, the tumor size, the depth of myometrial invasion (MI), the lympho-vascular involvement (LVI) and the USC and the EAC subtypes (considered as binary variables). Disease free survival (DFS), death of disease (DOD) and overall survival (OS) were assessed using univariate and multiple Cox proportional hazards models.
In univariate analysis, USC tends to recur more frequently than EAC (p = 0.004), a finding that disappeared in multivariate analysis. Furthermore, tumor histology had no significance in predicting the tumor outcomes. Among all of the prognostic factors and after adjusting for the aforementioned variables, MI ≥50% was the only independent factor in predicting DOD in stages II/III/IV (p = 0.009) and in stages III/IV (p = 0.004). MI was also an independent predictive factor for OS (p = 0.02) and early recurrences in stages III/IV. LVI was the only independent factor in predicting recurrences (p = 0.004) in stages II/III/IV but not in stages III/IV.
Based on our study, tumor histology was not a significant factor in predicting disease outcome in stages II/III/IV and II/IV. Despite our limited sample size, we believe that our findings provide meaningful insights into the clinical study of endometrial cancer patients which in turn warrants further investigation.
探讨并比较 II/III/IV 期和 III/IV 期子宫内膜样腺癌（EAC）与浆液性癌（USC）患者的预后。
共评估了 107 例患者（73 例 EAC 和 34 例 USC）。为了进行统计分析，考虑了以下基线变量的预后价值：患者的发病年龄、肿瘤大小、肌层浸润深度（MI）、淋巴血管侵犯（LVI）和 USC 以及 EAC 亚型（视为二项变量）。使用单变量和多 Cox 比例风险模型评估无病生存（DFS）、疾病死亡（DOD）和总生存（OS）。
在单变量分析中，USC 比 EAC 更易复发（p = 0.004），但在多变量分析中这种差异消失了。此外，肿瘤组织学对预测肿瘤结局没有意义。在所有预后因素中，在调整上述变量后，MI≥50%是 II/III/IV 期（p = 0.009）和 III/IV 期（p = 0.004）DOD 的唯一独立预测因素。MI 也是 OS（p = 0.02）和 III/IV 期早期复发的独立预测因素。LVI 是预测 II/III/IV 期复发的唯一独立因素（p = 0.004），但不是 III/IV 期。
根据我们的研究，肿瘤组织学不是预测 II/III/IV 期和 II/IV 期疾病结局的重要因素。尽管我们的样本量有限，但我们认为我们的发现为子宫内膜癌患者的临床研究提供了有意义的见解，这反过来需要进一步研究。
