J Gynecol Oncol.  2012 Oct;23(4):257-264. 10.3802/jgo.2012.23.4.257.

Risk factors for recurrence amongst high intermediate risk patients with endometrioid adenocarcinoma

• Bahng AY
• Chu C
• Wileyto P
• Rubin S
• Lin LL

• KMID: 1810123
• DOI: http://doi.org/10.3802/jgo.2012.23.4.257

Abstract

OBJECTIVE
To determine risk factors associated with recurrence in patients with high intermediate risk (HIR) endometrioid adenocarcinoma.
METHODS
A retrospective analysis of patients with HIR endometrioid adenocarcinoma who underwent hysterectomy, bilateral salpingo-oophorectomy, with or without pelvic/para-aortic lymphadenectomy at the University of Pennsylvania between 1990 and 2009 was performed.
RESULTS
A total of 103 women with HIR endometrial cancer were identified. Multivariable analysis revealed that > or =2/3 myometrial invasion (HR, 4.79; p=0.010) and grade 3 disease (HR, 3.04; p=0.045) were independently predictive of distant metastases. The 5-year distant metastases free survival (DMFS) for patients with neither or one of these risk factors was 89%, and the 5-year DMFS for patients with both risk factors was 48% (p<0.001).
CONCLUSION
Patients with both grade 3 disease and deep third myometrial invasion have a high risk of distant metastases. Identifying these patients may be important in rationally selecting patients for systemic therapy.

Keyword

Chemotherapy; Endometrial neoplasms; High intermediate risk; Radiotherapy

MeSH Terms

Carcinoma, Endometrioid
Endometrial Neoplasms
Female
Humans
Hysterectomy
Lymph Node Excision
Neoplasm Metastasis
Pennsylvania
Recurrence
Retrospective Studies
Risk Factors

Figure

• 

  Fig. 1 Kaplan-Meier curve for distant metastasis free-survival stratified by presence or absence of both grade 3 and deep myometrial invasion.

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