National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
World J Surg Oncol. 2023 Mar 27;21(1):106. doi: 10.1186/s12957-023-02992-0.
To evaluate the oncological outcomes and the impact of clinicopathological factors on endometrial clear cell carcinoma (ECCC) outcomes.
Medical records of patients with primary ECCC treated at our center between 1985 and December 2020 were reviewed. Overall survival (OS) and progression-free survival (PFS) were the endpoints. The Kaplan-Meier method and Cox regression analysis were used.
In total, 156 patients were included, of whom 59% and 41% had early- and advanced-stage ECCC, respectively. The median age of onset was 61 years, and 80.8% of the patients were postmenopausal. Ninety-two (59%) and 64 (41%) patients had pure ECCC and mixed endometrial carcinoma with clear cell carcinoma (CCC) components, respectively. Mixed pathological components, elevated cancer antigen 125 levels, positive lymphovascular space invasion, deep myometrial invasion, and malignant peritoneal washing cytology (PWC) were more frequently observed in the advanced stage. Thirty-nine patients (25%) experienced relapse and 32 patients (20.5%) died. The 5-year PFS and OS rates for the entire cohort were 72.6% and 79%, respectively. Multivariate analysis showed that advanced-stage disease and positive PWC significantly decreased PFS, while advanced-stage disease and older age (> 61 years) significantly decreased OS.
ECCC is a rare and aggressive type II endometrial carcinoma that is common in older women and patients with advanced-stage disease. Positive PWC was associated with decreased PFS, although its presence did not influence the stage. Positive PWC, and advanced stage and older age were independent negative prognostic factors.
评估子宫内膜透明细胞癌（ECCC）的肿瘤学结局和临床病理因素的影响。
回顾了 1985 年至 2020 年 12 月在我院治疗的原发性 ECCC 患者的病历。总生存期（OS）和无进展生存期（PFS）是终点。采用 Kaplan-Meier 法和 Cox 回归分析。
共纳入 156 例患者，其中 59%和 41%分别为早期和晚期 ECCC。发病中位年龄为 61 岁，80.8%的患者绝经后。92（59%）例和 64（41%）例患者为单纯 ECCC 和混合子宫内膜癌伴透明细胞癌（CCC）成分，分别。晚期时更常观察到混合病理成分、癌抗原 125 水平升高、阳性淋巴管血管间隙浸润、深肌层浸润和恶性腹膜洗涤细胞学（PWC）阳性。39 例（25%）患者复发，32 例（20.5%）患者死亡。全队列的 5 年 PFS 和 OS 率分别为 72.6%和 79%。多变量分析显示，晚期疾病和阳性 PWC 显著降低 PFS，而晚期疾病和年龄较大（>61 岁）显著降低 OS。
ECCC 是一种罕见且侵袭性的 II 型子宫内膜癌，常见于老年女性和晚期疾病患者。阳性 PWC 与 PFS 降低相关，尽管其存在并不影响分期。阳性 PWC 以及晚期和老年是独立的预后不良因素。
