Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer

Jen Ruei Chen, Ting Chang Chang, Hung Chun Fu, Hei Yu Lau, I. Hui Chen, Yu Min Ke, Yu-Ling Liang, An Jen Chiang, Chia Yen Huang, Yu Chieh Chen, Mun Kun Hong, Yu Chi Wang, Kuo Feng Huang, Sheng Mou Hsiao, Peng Hui Wang

Research output: Contribution to journalArticle

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Abstract

In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n=464; stage IV, n=77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P=0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P<0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P<0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P<0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P<0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P<0.001, and HR 0.14, 95% CI 0.08-0.26; P<0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P=0.017, and HR 0.48; 95% CI 0.31-0.75; P=0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.

Original languageEnglish
Article numbere3330
JournalMedicine (United States)
Volume95
Issue number15
DOIs
Publication statusPublished - 2016 Apr 1

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Endometrial Neoplasms
Confidence Intervals
Survival
Disease-Free Survival
Cohort Studies
Multivariate Analysis
Retrospective Studies
Lymph Nodes
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Chen, Jen Ruei ; Chang, Ting Chang ; Fu, Hung Chun ; Lau, Hei Yu ; Chen, I. Hui ; Ke, Yu Min ; Liang, Yu-Ling ; Chiang, An Jen ; Huang, Chia Yen ; Chen, Yu Chieh ; Hong, Mun Kun ; Wang, Yu Chi ; Huang, Kuo Feng ; Hsiao, Sheng Mou ; Wang, Peng Hui. / Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer. In: Medicine (United States). 2016 ; Vol. 95, No. 15.
@article{b1ab291d33d24ac0aa83573f9eca6ce9,
title = "Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer",
abstract = "In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n=464; stage IV, n=77). Five-year overall survival (OS) was 70.4{\%}. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95{\%} confidence interval [CI] 1.12-2.09; P=0.007), histological grade 3 (HR 2.0, 95{\%} CI 1.47-2.75; P<0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95{\%} CI 1.13-6.72; P<0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95{\%} CI 1.34-2.64; P<0.001), and histological grade 3 (HR 2.42, 95{\%} CI 1.75-3.35; P<0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95{\%} CI 0.16-0.45; P<0.001, and HR 0.14, 95{\%} CI 0.08-0.26; P<0.001) and the following paclitaxel-based therapy (HR 0.61, 95{\%} CI 0.79-0.92; P=0.017, and HR 0.48; 95{\%} CI 0.31-0.75; P=0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.",
author = "Chen, {Jen Ruei} and Chang, {Ting Chang} and Fu, {Hung Chun} and Lau, {Hei Yu} and Chen, {I. Hui} and Ke, {Yu Min} and Yu-Ling Liang and Chiang, {An Jen} and Huang, {Chia Yen} and Chen, {Yu Chieh} and Hong, {Mun Kun} and Wang, {Yu Chi} and Huang, {Kuo Feng} and Hsiao, {Sheng Mou} and Wang, {Peng Hui}",
year = "2016",
month = "4",
day = "1",
doi = "10.1097/MD.0000000000003330",
language = "English",
volume = "95",
journal = "Medicine (United States)",
issn = "0025-7974",
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}

Chen, JR, Chang, TC, Fu, HC, Lau, HY, Chen, IH, Ke, YM, Liang, Y-L, Chiang, AJ, Huang, CY, Chen, YC, Hong, MK, Wang, YC, Huang, KF, Hsiao, SM & Wang, PH 2016, 'Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer', Medicine (United States), vol. 95, no. 15, e3330. https://doi.org/10.1097/MD.0000000000003330

Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer. / Chen, Jen Ruei; Chang, Ting Chang; Fu, Hung Chun; Lau, Hei Yu; Chen, I. Hui; Ke, Yu Min; Liang, Yu-Ling; Chiang, An Jen; Huang, Chia Yen; Chen, Yu Chieh; Hong, Mun Kun; Wang, Yu Chi; Huang, Kuo Feng; Hsiao, Sheng Mou; Wang, Peng Hui.

In: Medicine (United States), Vol. 95, No. 15, e3330, 01.04.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of Patients with Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer

AU - Chen, Jen Ruei

AU - Chang, Ting Chang

AU - Fu, Hung Chun

AU - Lau, Hei Yu

AU - Chen, I. Hui

AU - Ke, Yu Min

AU - Liang, Yu-Ling

AU - Chiang, An Jen

AU - Huang, Chia Yen

AU - Chen, Yu Chieh

AU - Hong, Mun Kun

AU - Wang, Yu Chi

AU - Huang, Kuo Feng

AU - Hsiao, Sheng Mou

AU - Wang, Peng Hui

PY - 2016/4/1

Y1 - 2016/4/1

N2 - In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n=464; stage IV, n=77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P=0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P<0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P<0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P<0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P<0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P<0.001, and HR 0.14, 95% CI 0.08-0.26; P<0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P=0.017, and HR 0.48; 95% CI 0.31-0.75; P=0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.

AB - In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n=464; stage IV, n=77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P=0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P<0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P<0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P<0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P<0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P<0.001, and HR 0.14, 95% CI 0.08-0.26; P<0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P=0.017, and HR 0.48; 95% CI 0.31-0.75; P=0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.

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