Gorzelnik Katarzyna, Szubert Sebastian, Knafel Anna, Wójcikiewicz Anna, Nowakowski Błażej, Koper Krzysztof, Wicherek Łukasz
2 Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland.
Division of Gynaecological Oncology, Department of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland.
Contemp Oncol (Pozn). 2022;26(2):144-149. doi: 10.5114/wo.2022.118243. Epub 2022 Jun 30.
The primary aim of our study was to analyse the impact of the lymph node ratio (LNR) and extracapsular involvement (ECI) on the prognosis of endometrial cancer (EC) patients.
We carried out a retrospective analysis of 886 patients surgically treated for EC between 2000 and 2015. In the subgroup of patients with lymph node metastases (LNM), we evaluated the impact of the number and localization of the LNM, LNR, and ECI on patients' overall survival (OS).
In the group of patients with LNM, 0.3 was the optimal LNR cut-off for differentiating between short- and long-term survivors [HR = 2.94 (95% CI: 1.49-5.80)]. Patients with a LNR ≥ 0.3 had a significantly shorter OS period (35.0 months, range 0.2-175 months) compared to patients with a LNR < 0.3 [median OS - mOS, was 143, range 15-169 months; ( = 0.003]. We observed significant differences in the mOS of EC patients without LNM compared to patients with LNM, as well as those with both LNM and ECI ( < 0.0001). In the group of patients with LNM, we also found that a poorer prognosis depended on the extension of the primary tumour.
Our results suggest that when LNM are found, the long-term outcomes of EC patients are worse in those who have a LNR ≥ 0.3, the presence of ECI, and a more advanced extension of the primary tumour.
我们研究的主要目的是分析淋巴结比率（LNR）和包膜外侵犯（ECI）对子宫内膜癌（EC）患者预后的影响。
我们对2000年至2015年间接受手术治疗的886例EC患者进行了回顾性分析。在有淋巴结转移（LNM）的患者亚组中，我们评估了LNM的数量和位置、LNR以及ECI对患者总生存期（OS）的影响。
在有LNM的患者组中，0.3是区分短期和长期生存者的最佳LNR临界值[风险比（HR）=2.94（95%置信区间：1.49 - 5.80）]。与LNR<0.3的患者相比，LNR≥0.3的患者OS期显著更短（35.0个月，范围0.2 - 175个月）[中位OS - mOS为143个月，范围15 - 169个月；P = 0.003]。我们观察到无LNM的EC患者与有LNM的患者以及同时有LNM和ECI的患者相比，mOS存在显著差异（P<0.0001）。在有LNM的患者组中，我们还发现预后较差取决于原发肿瘤的范围。
我们的结果表明，当发现有LNM时，LNR≥0.3、存在ECI以及原发肿瘤范围更晚期的EC患者长期预后更差。
