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Prognostic significance of several histological features in intermediate and high‐risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy
Author(s) -
Narayan K,
Rejeki V,
Herschtal A,
Bernshaw D,
Quinn M,
Jobling T,
Allen D
Publication year - 2009
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2009.02045.x
Subject(s) - medicine , histology , grading (engineering) , endometrial cancer , lymphadenectomy , radiation therapy , lymph node , oncology , hysterectomy , cancer , radiology , civil engineering , engineering
Summary The purpose of the present study was to explore the prognostic significance of several histological features with respect to lymph node metastasis, failure‐free survival (FFS), and overall survival (OS) in intermediate and high‐risk endometrial cancer patients treated with curative intent. One hundred and eighty patients with endometrial cancer were treated with hysterectomy with or without lymphadenectomy and received external beam radiotherapy (EBRT). The mean follow‐up period was 4.25 years (range 0.44–10.45 years). In multifactor analysis, fractional myometrial invasion (MI) ( P = 0.047), histology ( P < 0.001) and lymph‐vascular space invasion (LVSI) ( P = 0.025) were significant predictors for FFS when nodal status was not included. When lymph node status was known, histology ( P = 0.007) and LVSI ( P = 0.014) remained significant factors for FFS. For OS, histology ( P < 0.001) and fractional MI ( P = 0.004) were the significant factors. Lymph node status could be predicted by tumour grading ( P = 0.016) and absolute MI ( P = 0.002). Histology type and the presence of LVSI were the most important prognostic factors in high‐risk endometrial cancer patients treated by surgery and postoperative radiotherapy. Absolute MI and tumour grading were useful predictors of nodal spread.