Tumor type in prediction of survival in patients with endometrial cancer
Keywords:
type of endometrial cancer, disease free survivalAbstract
Introduction. An ability to predict survival is of crucial importance in determining the need for cancer therapy.
Aim. The purpose of this study was to evaluate whether updated tumor type predicts 5-year disease free survival (DFS) for patients with endometrial cancer.
Material and methods. Two hundred and eighteen patients who received primary surgical treatment for endometrial cancer were enrolled in this study. The clinical outcomes were compared among the patients with type I and II of endometrial cancer.
Results. Among 218 patients in 174 cases were confirmed type I endometrial cancer and in 44 cases were type II. The 5-year DFS of the entire group was 72% in patients with type I tumors and 34% in patients with type II endometrial cancer (p<0.001). The 5-year DFS was 92% for patients with stage I, 70% for patients with stage II and 13% for stage III in type I endometrial cancer compared with 60%, 45% and 0% for those with type II, respectively (p<0.001 and p=0.86, respectively). Tumor grade are the most important factors in type I endometrial cancer and correlated with DFS (p=0.0072).
Conclusions. Clinical stage is the most important prognostic factor in type I endometrial cancer. Type II of endometrial cancers is associated with poor prognosis even when at stage I.
References
1. Horner MJ, Ries LAG, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009.
2. Stewart BW, Kleihues P. World cancer report. Lyon: IARCPress, 2003.
3. Reports based on data of National Cancer Registry. The Maria Sklodowska-Curie memorial Cancer Center, Department of Epidemiology and Cancer Prevetion, National Cancer Registry 2004, http://epid.coi.waw.pl/krn.
4. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366(9484):491-505.
5. Münstedt K, Grant P, Woenckhaus J, Roth G, Tinneberg HR. Cancer of the endometrium: current aspects of diagnostics and treatment. World J Surg Oncol. 2004;2:24.
6. Bansal S, Buck AM, Herzog TJ, Deutsch I, Burke WM, Wright JD. Stage IIIA endometrial carcinoma: outcome and predictors of survival. Obstet Gynecol. 2009;114(1):100-5.
7. Hoekstra AV, Kim RJ, Small W Jr, Rademaker AW, Helenowski IB, Singh DK, Schink JC, Lurain JR. FIGO stage IIIC endometrial carcinoma: prognostic factors and outcomes. Gynecol Oncol. 2009;114(2):273-8.
8. Cannon GM, Geye H, Terakedis BE, Kushner DM, Connor JP, Hartenbach EM, Bradley KA. Outcomes following surgery and adjuvant radiation in stage II endometrial adenocarcinoma. Gynecol Oncol. 2009;113(2):176-80.
9. Maneschi M, Maneschi F, Geraci P, Licata MD, Serruto A, Attanasio P, Curcio P. Surgical pathological staging of endometrial carcinoma and results of treatment. Eur J Gynaecol Oncol. 1992;13(Suppl 1):30-5.
10. Wolfson AH, Sightler SE, Markoe AM, Schwade JG, Averette HE, Ganjei P, Hilsenbeck SG. The prognostic significance of surgical staging for carcinoma of the endometrium. Gynecol Oncol. 1992;45(2):142-6.
11. Byrd LM, Swindell R, Webber-Rookes D, Hannon R, Hunter RD, Livsey J, Davidson SE. Endometrial adenocarcinoma: an analysis of treatment and outcome. Oncol Rep. 2008;20(5):1221-8.
12. Zaino RJ, Kurman RJ, Brunetto VL, Morrow CP, Bentley RC, Cappellari JO, Bitterman P. Villoglandular adenocarcinoma of the endometrium: a clinicopathologic study of 61 cases: a gynecologic oncology group study. Am J Surg Pathol. 1998;22(11):1379-85.
13. Sanjuán A, Cobo T, Escaramís G, Rovirosa A, Ordi J, García S, Hernández S, Caparrós X, Torné A, Martínez Román S, Lejárcegui JA, Pahisa J. Recurrence and survival in surgically treated endometrioid endometrial cancer. Clin Transl Oncol. 2008;10(8):505-11.
14. Lax SF, Kurman RJ, Pizer ES, Wu L, Ronnett BM. A binary architectural grading system for uterine endometrial endometrioid carcinoma has superior reproducibility compared with FIGO grading and identifies subsets of advance-stage tumors with favorable and unfavorable prognosis. Am J Surg Pathol. 2000;24(9):1201-8.
