Yang Dong, Zhang Xiaoli, Tan Yini, Li Pian, He Junyan, Li Yi
Department of Oncology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
Department of Pathology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
Sci Rep. 2025 Jul 21;15(1):26506. doi: 10.1038/s41598-025-12399-4.
Background It is crucial to identify the high-risk factors associated with the recurrence and metastasis of endometrial cancer (EC) in order to implement more precise clinical stratification and management strategies for EC patients. Methods A total of 336 patients with stage I-III EC were retrospectively analyzed. According to the recurrence site, they were divided into locoregional recurrence (LR) and poor-prognosis recurrence (PPR). The factors that may affect the prognosis of EC were analyzed and the subgroups were analyzed. Results Among the no recurrence (NR), LR and PPR groups, 5-year OS were 89.4%, 60.2% and 46.8%, 5-year RFS were 100%, 15.4% and 6.4%. The FIGO stage, molecular classification, lymphovascular space invasion (LVSI) and smoking history were independent risk factors affecting 5-year OS and 5-year RFS in EC patients (p < 0.05). Pathological type and progesterone receptor (PR) were independent risk factors affecting 5-year OS (p < 0.05). Histologic Grade and adjuvant therapy were independent risk factors affecting 5-year RFS (p < 0.05). Myometrial invasion, LVSI and FIGO stage were independent risk factors in the LR subgroup (p < 0.05), FIGO stage, ER and PR were independent risk in the PPR subgroup (p < 0.05). Conclusions Patients with myometrial invasion ≥ 1/2 and substantial LVSI may be more likely to have LR, while patients with positive ER and PR are more likely to have PPR. We need to pay attention to these factors to help us judge the prognosis of EC patients.
识别与子宫内膜癌（EC）复发和转移相关的高危因素对于为EC患者实施更精确的临床分层和管理策略至关重要。方法：回顾性分析336例I-III期EC患者。根据复发部位，将他们分为局部区域复发（LR）和预后不良复发（PPR）。分析可能影响EC预后的因素并进行亚组分析。结果：在无复发（NR）、LR和PPR组中，5年总生存率（OS）分别为89.4%、60.2%和46.8%，5年无复发生存率（RFS）分别为100%、15.4%和6.4%。国际妇产科联盟（FIGO）分期、分子分类、淋巴血管间隙浸润（LVSI）和吸烟史是影响EC患者5年OS和5年RFS的独立危险因素（p<0.05）。病理类型和孕激素受体（PR）是影响5年OS的独立危险因素（p<0.05）。组织学分级和辅助治疗是影响5年RFS的独立危险因素（p<0.05）。肌层浸润、LVSI和FIGO分期是LR亚组的独立危险因素（p<0.05），FIGO分期、雌激素受体（ER）和PR是PPR亚组的独立危险因素（p<0.05）。结论：肌层浸润≥1/2且LVSI显著的患者可能更易发生LR，而ER和PR阳性的患者更易发生PPR。我们需要关注这些因素以帮助判断EC患者的预后。
