Shao Wenyu, Xue Yu, Xu Zhiying, Guan Jun, Wang Huaying, Chen Xiaojun, Ren Yulan
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Front Oncol. 2025 Feb 27;15:1450054. doi: 10.3389/fonc.2025.1450054. eCollection 2025.
To evaluate the impact of depth of cervical stromal invasion (CSI) on the prognosis of International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).
Patients with FIGO stage II EEC confirmed by postoperative histopathology and consecutively admitted to the Obstetrics and Gynecology Hospital of Fudan University and Fudan University Shanghai Cancer Center between 2008 and 2017 were included in this study and reviewed retrospectively.
Two hundred and ninety-seven patients were included in this study. There were 253 (253/297, 85.2%)patients with superficial (<50%) and 44 (44/297, 14.8%) cases with deep (≥50%) CSI. The median follow-up time was 75.0 months (range: 5-175 months). Patients in the ≥50% CSI group had a poorer prognosis compared to the <50% CSI group (recurrence-free survival [RFS]: adjusted hazard ratio [aHR] = 6.077, 95% Confidence Interval [CI]: 2.275-16.236, disease-specific survival [DSS]: aHR = 7.259, 95% CI: 2.546-20.695). Deep CSI was an independent predictor of local recurrence (aHR=5.537, 95% CI: 1.804-16.991). Post operative external beam radiation therapy (EBRT) was correlated with a reduced risk of recurrence (aHR = 0.288, 95% CI: 0.097-0.859).
Deep CSI is a poor prognostic factor for RFS and DSS in patients with FIGO stage II EEC. Postoperative EBRT can improve both RFS and DSS. Those findings imply that a detailed pathological report on the depth of CSI would be helpful in better understanding its impact on prognosis and selecting an appropriate postoperative treatment for the patient.
评估宫颈基质浸润深度（CSI）对国际妇产科联盟（FIGO）II期子宫内膜样腺癌（EEC）预后的影响。
本研究纳入2008年至2017年间在复旦大学附属妇产科医院和复旦大学附属肿瘤医院连续收治的、经术后组织病理学确诊为FIGO II期EEC的患者，并进行回顾性分析。
本研究共纳入297例患者。其中，253例（253/297，85.2%）患者为浅肌层浸润（<50%），44例（44/297，14.8%）患者为深肌层浸润（≥50%）。中位随访时间为75.0个月（范围：5 - 175个月）。与浅肌层浸润组相比，深肌层浸润组患者的预后较差（无复发生存期[RFS]：校正风险比[aHR]=6.077，95%置信区间[CI]：2.275 - 16.236；疾病特异性生存期[DSS]：aHR = 7.259，95% CI：2.546 - 20.695）。深肌层浸润是局部复发的独立预测因素（aHR = 5.537，95% CI：1.804 - 16.991）。术后体外放疗（EBRT）与复发风险降低相关（aHR = 0.288，95% CI：0.097 - 0.859）。
深肌层浸润是FIGO II期EEC患者RFS和DSS的不良预后因素。术后EBRT可改善RFS和DSS。这些发现表明，一份关于肌层浸润深度的详细病理报告有助于更好地理解其对预后的影响，并为患者选择合适的术后治疗方案。
