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Why do some patients with stage 1A and 1B endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors
, 1, 2, 2, 3, 3, 1, 4, 5, 5, 6, 1, 1, 1
Affiliations- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Türkiye
- Department of Surgical Pathology, Faculty of Medicine, Uludag University, Bursa, Türkiye
- Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Türkiye
- Department of Medical Oncology, Faculty of Medicine, Sitki Kocman University, Mugla, Türkiye
- Department of Gynecologic Oncology, Faculty of Medicine, Uludag University, Bursa, Türkiye
- Department of Radiation Oncology, Faculty of Medicine, Uludag University, Bursa, Türkiye
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Abstract
Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC.
Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files.
Results: The median age of the patients was 60 years (range 31–89). The median follow-up time of the patients was 63.6 months (range 3.3–185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients.
Conclusions: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.
Abstract
Objectives: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC.
Material and methods: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files.
Results: The median age of the patients was 60 years (range 31–89). The median follow-up time of the patients was 63.6 months (range 3.3–185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients.
Conclusions: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.
Keywords
endometrial endometrioid carcinoma; early stage; recurrence-free survival; ki-67; grade; tumor size
About this articleTitle
Why do some patients with stage 1A and 1B endometrial endometrioid carcinoma experience recurrence? A retrospective study in search of prognostic factors
Journal
Issue
Article type
Research paper
Pages
112-120
Published online
2021-05-14
Page views
7502
Article views/downloads
1512
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(2):112-120.
Keywords
endometrial endometrioid carcinoma
early stage
recurrence-free survival
ki-67
grade
tumor size
Authors
Birol Ocak
Ahmet Bilgehan Sahin
Fatma Oz Atalay
Mine Ozsen
Bahar Dakiki
Seray Ture
Seda Sali
Ozgur Tanriverdi
Mehmet Bayrak
Hakan Ozan
Candan Demiroz Abakay
Adem Deligonul
Erdem Cubukcu
Turkkan Evrensel
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