Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
J Gynecol Oncol. 2019 Jan;30(1):e8. doi: 10.3802/jgo.2019.30.e8. Epub 2018 Oct 2.
To develop and validate a 3-year recurrence prediction score (RPS) system for predicting the baseline risk of recurrence of stage I-II endometrial carcinoma.
We reviewed 427 patients with International Federation of Gynecology and Obstetrics staging I-II endometrial carcinoma underwent surgery without any adjuvant therapy from 2005 to 2013. The patients were divided into 2 groups: the test cohort (n=251) comprising those who underwent surgery in odd-numbered years, and the validation cohort (n=176) comprising those who underwent surgery in even-numbered years. Multivariate analysis was performed using 7 candidate predictors to identify the risk factors for 3-year recurrence-free interval (RFI) in the test cohort. Each risk factor was scored based on logistic regression analyses of the test data set, and the sum of the risk factor scores was defined as the RPS system. We then applied the system in the validation cohort.
Multivariate analysis revealed that the significant risk factors were age ≥60 years, pathological type II, positive cervical stromal invasion, and positive peritoneal cytology. In the test cohort, the 3-year RFI rates were 100%, 95.8%, 79.9%, and 33.3% for RPSs of 0, 1, 2, and 3, respectively. In the validation cohort, the 3-year RFI was significantly higher in the low-RPS group (RPS 0 or 1) than in the high-RPS group (RPS 2 or 3) (95.2% vs. 79.9%, p<0.01).
The RPS system shows significant reproducibility for predicting the baseline risk of recurrence. The system could potentially impact the choice of adjuvant therapy for stage I-II endometrial carcinoma.
开发和验证一个用于预测 I 期-II 期子宫内膜癌患者基线复发风险的 3 年复发预测评分（RPS）系统。
我们回顾了 2005 年至 2013 年间接受手术且未接受任何辅助治疗的 427 名国际妇产科联合会（FIGO）分期为 I 期-II 期子宫内膜癌患者。将患者分为两组：试验队列（n=251）包括在奇数年份接受手术的患者，验证队列（n=176）包括在偶数年份接受手术的患者。使用 7 个候选预测因子对试验队列中 3 年无复发生存期（RFI）的风险因素进行多变量分析。根据试验数据集的逻辑回归分析，对每个风险因素进行评分，将风险因素评分的总和定义为 RPS 系统。然后将该系统应用于验证队列。
多变量分析显示，年龄≥60 岁、病理类型 II、宫颈间质浸润阳性和腹腔细胞学阳性是显著的风险因素。在试验队列中，RPS 为 0、1、2 和 3 的患者 3 年 RFI 率分别为 100%、95.8%、79.9%和 33.3%。在验证队列中，低 RPS 组（RPS 0 或 1）的 3 年 RFI 显著高于高 RPS 组（RPS 2 或 3）（95.2% vs. 79.9%，p<0.01）。
RPS 系统在预测 I 期-II 期子宫内膜癌患者的基线复发风险方面具有显著的可重复性。该系统可能会影响 I 期-II 期子宫内膜癌患者辅助治疗的选择。
