Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France; INSERM U1069, Université François-Rabelais, Tours, France.
Department of Obstetrics and Gynaecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC-6 UPMC, Université Pierre et Marie Curie, Paris 6, France; UMR S 707, Epidemiology, Information Systems, Modeling, Université Pierre et Marie Curie, Paris, France.
Eur J Surg Oncol. 2018 Dec;44(12):1914-1920. doi: 10.1016/j.ejso.2018.07.053. Epub 2018 Jul 31.
Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. The objectives of this study were to identify patterns of recurrence in women with operable endometrial cancer (EC) and to identify high-risk periods for recurrence in function of age.
The data of 1153 women who received primary surgical treatment for stage I-III EC between January 2001 and December 2013 were abstracted from a prospectively maintained multicentre database. The time to first recurrence was calculated from the date of diagnosis, and the associated hazard function was examined to determine the peak risk period of recurrence. We categorized age at diagnosis as <65 and ≥ 65 years old and analysed the hazard rate (HR) by stratifying age groups.
Women with EC aged ≥65 years maintain a significant recurrence rate during follow-up whatever the stratification (locoregional recurrence, distant recurrence, ESMO/ESGO/ESTRO subgroup). Multivariable Cox proportional hazard regression showed that the increased risk of recurrence of EC was associated with advanced age, advanced disease ESMO/ESGO/ESTRO subgroup but not with initial treatment received.
The annual HR of recurrence is not uniformly distributed over time but is dynamic and markedly determined by prognostic factors at diagnosis.
预测复发模式有助于制定有针对性的监测和治疗策略。本研究的目的是确定可手术治疗的子宫内膜癌（EC）患者的复发模式，并确定与年龄相关的复发高危期。
从一个前瞻性维护的多中心数据库中提取了 2001 年 1 月至 2013 年 12 月期间接受 I-III 期 EC 原发性手术治疗的 1153 名女性的数据。首次复发的时间从诊断日期开始计算，并检查相关危险函数以确定复发的高峰风险期。我们将诊断时的年龄分为<65 岁和≥65 岁，并通过分层年龄组分析危险率（HR）。
无论分层如何（局部区域复发、远处复发、ESMO/ESGO/ESTRO 亚组），年龄≥65 岁的 EC 患者在随访期间保持显著的复发率。多变量 Cox 比例风险回归显示，EC 复发风险增加与年龄较大、疾病进展 ESMO/ESGO/ESTRO 亚组有关，但与初始治疗无关。
复发的年 HR 不是均匀分布在时间上的，而是动态的，并且主要由诊断时的预后因素决定。
