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Prognostic factors and patterns of recurrence in lymphovascular space invasion positive women with stage IIIC endometriod endometrial cancer
Author(s) -
Cuylan Zeliha F.,
Oz Murat,
Ozkan Nazli T.,
Comert Gunsu K.,
Sahin Hanifi,
Turan Taner,
Akbayir Ozgur,
Kuscu Esra,
Celik Husnu,
Dede Murat,
Gungor Tayfun,
Meydanli Mehmet M.,
Ayhan Ali
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13615
Subject(s) - medicine , hazard ratio , lymphovascular invasion , stage (stratigraphy) , endometrial cancer , oncology , retrospective cohort study , proportional hazards model , confidence interval , gastroenterology , gynecology , cancer , metastasis , paleontology , biology
Aim The purpose of this study was to determine the prognostic factors and patterns of failure in lymphovascular space invasion (LVSI)‐positive women with stage IIIC endometrioid endometrial cancer (EC). Methods A multicenter, retrospective, department database review was performed to identify LVSI‐positive patients with stage IIIC endometrioid EC at five gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results We identified 172 LVSI‐positive women with stage IIIC endometrioid EC during the study period; 75 (43.6%) were classified as Stage IIIC 1 and 97 (56.4%) as Stage IIIC 2 . The median age at diagnosis was 59 years, and the median duration of follow up was 34.5 months. The total number of recurrences was 46 (26.7%). We observed 14 (8.1%) locoregional recurrences, 12 (7.0%) retroperitoneal failures and 20 (11.6%) distant relapses. For the entire study cohort, 5‐year progression‐free survival (PFS) was 67.4%, while the 5‐year overall survival (OS) rate was 75.1%. Grade 3 histology (hazard ratio [HR] 2.62, 95% confidence interval [CI] 1.34–5.12; P = 0.005), cervical stromal invasion (HR 2.33, 95% CI 1.09–4.99; P = 0.028) and myometrial invasion (MMI) ≥50% (HR 4.0, 95% CI 1.16–13.69; P = 0.028) were found to be independent prognostic factors for decreased OS. Conclusion Uterine factors such as grade 3 disease, cervical stromal invasion and deep MMI seem to be independently associated with decreased OS in LVSI‐positive women with stage IIIC endometrioid EC. The high distant recurrence rate in this subgroup of patients warrants further studies in order to identify the most effective treatment strategy for those patients.