Departments of Radiation Oncology.
Alexandria Clinical Oncology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Am J Clin Oncol. 2023 Oct 1;46(10):445-449. doi: 10.1097/COC.0000000000001033. Epub 2023 Aug 1.
The objective of this study was to investigate the prognostic significance of the depth of cervical stromal invasion (CSI) in women with FIGO stage II uterine endometrioid adenocarcinoma (EC).
Our database of women with EC was quired for patients with stage II EC. Pathologic slides were retrieved and reviewed by gynecologic pathologists to determine cervical stromal thickness and depth of CSI as a percentage of stromal thickness (%CSI). Kaplan-Meier, univariate, and multivariate analyses were used to compare recurrence-free, disease-specific (DSS), and overall survival (OS) between women who had<50% versus ≥50% CSI. Univariate and multivariate analyses were used to assess other prognostic variables associated with survival endpoints.
A total of 117 patients were included in our study who had hysterectomy between 1/1990 and 8/2021. Seventy-nine patients (68%) with <50% and 38 (32w%) with ≥50% CSI. After a median follow-up of 131 months, 5-year DSS was significantly worse for women with ≥50% CSI (78% vs. 91%; P =0.04). However, %CSI was not an independent predictor for any of the studied survival endpoints. Independent predictors of worse 5-year recurrence-free survival and DSS included FIGO grade 3 tumors ( P =0.02) and the presence of lymphovascular space invasion ( P =0.03). Grade 3 tumors were the only independent predictor of worse 5-year OS ( P =0.02).
Our results suggest that deep CSI is not an independent prognostic factor for survival endpoints in women with stage II uterine endometroid adenocarcinoma. The lack of independent prognostic significance of the depth CSI needs to be validated in a multi-institutional analysis.
本研究旨在探讨国际妇产科联盟（FIGO）分期为 II 期的子宫子宫内膜样腺癌（EC）患者中宫颈间质浸润（CSI）深度的预后意义。
我们查询了患有 EC 的患者数据库，以获取 II 期 EC 患者的信息。检索并由妇科病理学家审查病理切片，以确定宫颈间质厚度和 CSI 深度占间质厚度的百分比（%CSI）。采用 Kaplan-Meier 法、单因素和多因素分析比较 CSI<50%与≥50%的患者之间无复发生存率（RFS）、疾病特异性生存（DSS）和总生存率（OS）。还使用单因素和多因素分析评估了与生存终点相关的其他预后变量。
本研究共纳入了 117 例于 1990 年 1 月至 2021 年 8 月期间接受子宫切除术的患者。79 例（68%）患者的 CSI<50%，38 例（32%）患者的 CSI≥50%。中位随访 131 个月后，CSI≥50%的患者 5 年 DSS 显著更差（78% vs. 91%；P=0.04）。然而，%CSI 并不是任何研究生存终点的独立预测因素。更差的 5 年无复发生存率和 DSS 的独立预测因素包括 FIGO 分级 3 肿瘤（P=0.02）和存在脉管侵犯（P=0.03）。3 级肿瘤是 5 年 OS 更差的唯一独立预测因素（P=0.02）。
我们的结果表明，CSI 深度不是 II 期子宫子宫内膜样腺癌患者生存终点的独立预后因素。CSI 深度的独立预后意义尚需在多机构分析中验证。
