Corey Logan, Fucinari Juliana, Elshaikh Mohamed, Schultz Daniel, Musallam Rami, Zaiem Feras, Daaboul Fayez, Fehmi Omar, Dyson Greg, Ruterbusch Julie, Morris Robert, Cote Michelle L, Ali-Fehmi Rouba, Bandyopadhyay Sudeshna
Wayne State University, School of Medicine, Department of Oncology, Detroit, Michigan.
Karmanos Cancer Institute, Department of Gynecologic Oncology, Detroit, Michigan.
Gynecol Oncol Rep. 2021 Jul 12;37:100830. doi: 10.1016/j.gore.2021.100830. eCollection 2021 Aug.
The aim of this study was to evaluate the prognostic value of peritoneal cytology status among other clinicopathological parameters in uterine serous carcinoma (USC).
A retrospective study of 148 patients diagnosed with uterine serous carcinoma from 1997 to 2016 at two academic medical centers in the Detroit metropolitan area was done. A central gynecologic pathologist reviewed all available slides and confirmed the histologic diagnosis of each case of USC. We assessed the prognostic impact of various clinicopathological parameters on overall survival (OS) and endometrial cancer-specific survival (ECSS). Those parameters included race, body mass index (BMI), stage at diagnosis, tumor size, lymphovascular invasion (LVSI), peritoneal cytology status, receipt of adjuvant treatment, and comorbidity count using the Charlson Comorbidity Index (CCI). We used Cox proportional hazards models and 95% confidence intervals for statistical analysis.
Positive peritoneal cytology had a statistically significant effect on OS (HR: 2.09, 95% CI: [1.19, 3.68]) and on ECSS (HR: 2.02, 95% CI: [1.06 - 3.82]). LVSI had a statistically significant effect on both OS (HR: 2.27, 95% CI: [1.14, 4.53]) and ECSS (HR: 3.45, 95% CI: [1.49, 7.99]). Black or African American (AA) race was also found to have a significant effect on both OS (HR: 1.92, 95% CI: [1.07, 3.47]) and ECSS (HR: 2.01, 95% CI: [1.02, 3.98]). Other factors including BMI and tumor size > 1 cm did not show a statistically significant impact on OS or ECSS.
Peritoneal washings with positive cytology and LVSI are important prognostic tools that may have a significant impact on overall survival in USC and can be used as independent negative prognosticators to help guide adjuvant treatment.
本研究旨在评估在子宫浆液性癌（USC）中，腹膜细胞学状态相较于其他临床病理参数的预后价值。
对1997年至2016年期间在底特律都会区的两个学术医疗中心诊断为子宫浆液性癌的148例患者进行回顾性研究。一位中心妇科病理学家复查了所有可用切片，并确认了每例USC的组织学诊断。我们评估了各种临床病理参数对总生存期（OS）和子宫内膜癌特异性生存期（ECSS）的预后影响。这些参数包括种族、体重指数（BMI）、诊断时的分期、肿瘤大小、淋巴管浸润（LVSI）、腹膜细胞学状态、辅助治疗的接受情况以及使用Charlson合并症指数（CCI）计算的合并症数量。我们使用Cox比例风险模型和95%置信区间进行统计分析。
阳性腹膜细胞学对OS（风险比：2.09，95%置信区间：[1.19, 3.68]）和ECSS（风险比：2.02，95%置信区间：[1.06 - 3.82]）有统计学显著影响。LVSI对OS（风险比：2.27，95%置信区间：[1.14, 4.53]）和ECSS（风险比：3.45，95%置信区间：[1.49, 7.99]）均有统计学显著影响。还发现黑人或非裔美国人（AA）种族对OS（风险比：1.92，95%置信区间：[1.07, 3.47]）和ECSS（风险比：2.01，95%置信区间：[1.02, 3.98]）均有显著影响。包括BMI和肿瘤大小>1 cm在内的其他因素对OS或ECSS未显示出统计学显著影响。
细胞学阳性的腹膜冲洗液和LVSI是重要的预后工具，可能对USC的总生存期有显著影响，可作为独立的不良预后指标来帮助指导辅助治疗。
