Tanaka Kei, Kobayashi Yoichi, Sugiyama Juri, Yamazaki Tatsuo, Dozono Kei, Watanabe Momoe, Shibuya Hiromi, Nishigaya Yoshiko, Momomura Mai, Matsumoto Hironori, Umezawa Satoshi, Takamatsu Kiyoshi, Iwashita Mitsutoshi
Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
The Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Int J Clin Oncol. 2017 Jun;22(3):533-540. doi: 10.1007/s10147-016-1079-5. Epub 2017 Jan 12.
Prognostic clinicopathological factors for type 1 endometrial cancer are unknown and the purpose of the current study was to determine the independent prognostic variables for type 1 endometrial cancer.
We performed a retrospective study of 168 patients with type 1 endometrial cancer primarily treated with comprehensive staging surgery. The median follow-up time was 68 (12-100) months. Independent risk factors for disease-free survival (DFS) and overall survival (OS) were determined using multivariate Cox regression models. Sub-group analysis of stage I was also performed. We also assessed the patterns of failure among patients with recurrences and investigated the associations with the prognostic variables determined by multivariate analysis.
Twenty patients (11.9%) had recurrence and 13 patients (7.7%) died of the disease overall. Multivariate analysis revealed that grade 2 (G2) histology (p = 0.008) and positive peritoneal cytology (p = 0.001) predicted the recurrent event in type 1 endometrial cancer. G2 histology (p = 0.007) and positive peritoneal cytology (p = 0.003) were also found to be independent risk factors for tumor-related deaths. Among stage I patients, G2 histology and positive peritoneal cytology were also independent prognostic variables for DFS and OS. Patients with G2 histology and/or positive peritoneal cytology were more likely to have recurrence at distant sites.
G2 histology and positive peritoneal cytology were independent prognostic factors for DFS and OS in type 1 endometrial cancer.
1型子宫内膜癌的预后临床病理因素尚不清楚，本研究的目的是确定1型子宫内膜癌的独立预后变量。
我们对168例主要接受全面分期手术治疗的1型子宫内膜癌患者进行了回顾性研究。中位随访时间为68（12 - 100）个月。使用多变量Cox回归模型确定无病生存期（DFS）和总生存期（OS）的独立危险因素。还对I期进行了亚组分析。我们还评估了复发患者的失败模式，并研究了与多变量分析确定的预后变量的相关性。
20例患者（11.9%）复发，13例患者（7.7%）总体死于该疾病。多变量分析显示，2级（G2）组织学（p = 0.008）和阳性腹膜细胞学（p = 0.001）可预测1型子宫内膜癌的复发事件。G2组织学（p = 0.007）和阳性腹膜细胞学（p = 0.003）也被发现是肿瘤相关死亡的独立危险因素。在I期患者中，G2组织学和阳性腹膜细胞学也是DFS和OS的独立预后变量。具有G2组织学和/或阳性腹膜细胞学的患者更有可能在远处复发。
G2组织学和阳性腹膜细胞学是1型子宫内膜癌DFS和OS的独立预后因素。
