Alhadeethi Abdulhameed, Ibrahim Ahmed A, Atia Ahmed, Alabdallat Yasmeen J, Alkhawaldeh Ibraheem M, El Din Moawad Mostafa H
Department of General Medicine, Al-Salam Teaching Hospital, Mosul, IRQ.
Cardiology, Faculty of Medicine, Menofia University, Menofia, EGY.
Cureus. 2024 Feb 21;16(2):e54606. doi: 10.7759/cureus.54606. eCollection 2024 Feb.
Background There are several patterns of metastatic spread from endometrial cancer (EC). Although studies have been conducted to study the EC population with distant metastasis in the bone and lungs, there is still a lack of studies on liver metastasis. This study aims to evaluate and assess the clinical features and prognostic factors of EC patients with liver metastasis. Methodology We conducted a retrospective cohort study adhering to the guidelines for reporting observational research. We utilized the Surveillance, Epidemiology, and End Results database to gather data on female patients diagnosed with EC and reported liver metastasis. We estimated survival curves using the Kaplan-Meier method and evaluated differences in survival using the log-rank test. We also conducted univariable and multivariable Cox proportional hazards regression analyses to determine the hazard ratios with 95% confidence intervals for overall survival (OS) and identify factors that impact survival. Results We analyzed data from 1,034 EC patients with liver metastasis. Median OS after liver metastasis was six months, and cancer-specific survival was seven months. Univariate Cox regression analysis revealed several factors associated with decreased OS in EC patients. These included age (≥60 years), non-endometrioid and sarcoma histological subtypes, absence of surgery, no chemotherapy, and the presence of distant metastasis to the lung, brain, and bone. Conversely, married marital status and white race were linked to a better prognosis. Subsequent multivariate Cox regression analysis identified age (≥60 years), non-endometrioid histological subtype, absence of surgery, no chemotherapy, and the presence of distant metastasis to lung, brain, and bone remaining as independent risk factors for decreased OS. In contrast, the white race still emerged as an independent prognostic factor for better OS. Conclusions Various risk factors, such as age, race, lung, bone, or brain metastasis, as well as chemotherapy and surgery, may influence the prognosis of individuals with primary EC liver metastases.
子宫内膜癌（EC）存在多种转移扩散模式。尽管已有研究针对骨和肺远处转移的EC患者群体展开，但关于肝转移的研究仍较为匮乏。本研究旨在评估EC肝转移患者的临床特征及预后因素。方法：我们遵循观察性研究报告指南进行了一项回顾性队列研究。利用监测、流行病学和最终结果数据库收集诊断为EC并报告有肝转移的女性患者数据。使用Kaplan-Meier方法估计生存曲线，并通过对数秩检验评估生存差异。我们还进行了单变量和多变量Cox比例风险回归分析，以确定总生存（OS）的风险比及95%置信区间，并识别影响生存的因素。结果：我们分析了1034例EC肝转移患者的数据。肝转移后的中位OS为6个月，癌症特异性生存为7个月。单变量Cox回归分析揭示了EC患者中与OS降低相关的几个因素。这些因素包括年龄（≥60岁）、非子宫内膜样和肉瘤组织学亚型、未进行手术、未接受化疗以及存在肺、脑和骨的远处转移。相反，已婚婚姻状况和白种人与较好的预后相关。随后的多变量Cox回归分析确定年龄（≥60岁）、非子宫内膜样组织学亚型、未进行手术、未接受化疗以及存在肺、脑和骨的远处转移仍然是OS降低的独立危险因素。相比之下，白种人仍然是OS较好的独立预后因素。结论：年龄、种族、肺、骨或脑转移以及化疗和手术等各种危险因素可能影响原发性EC肝转移患者的预后。
