Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study

ObjectiveTo evaluate the impact of depth of cervical stromal invasion (CSI) on the prognosis of International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).MethodsPatients with FIGO stage II EEC confirmed by postoperative histopathology and consecutive...

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Main Authors: Wenyu Shao, Yu Xue, Zhiying Xu, Jun Guan, Huaying Wang, Xiaojun Chen, Yulan Ren
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1450054/full
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author Wenyu Shao
Yu Xue
Zhiying Xu
Jun Guan
Huaying Wang
Huaying Wang
Xiaojun Chen
Xiaojun Chen
Yulan Ren
Yulan Ren
author_facet Wenyu Shao
Yu Xue
Zhiying Xu
Jun Guan
Huaying Wang
Huaying Wang
Xiaojun Chen
Xiaojun Chen
Yulan Ren
Yulan Ren
author_sort Wenyu Shao
collection DOAJ
description ObjectiveTo evaluate the impact of depth of cervical stromal invasion (CSI) on the prognosis of International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).MethodsPatients with FIGO stage II EEC confirmed by postoperative histopathology and consecutively admitted to the Obstetrics and Gynecology Hospital of Fudan University and Fudan University Shanghai Cancer Center between 2008 and 2017 were included in this study and reviewed retrospectively.ResultsTwo hundred and ninety-seven patients were included in this study. There were 253 (253/297, 85.2%)patients with superficial (<50%) and 44 (44/297, 14.8%) cases with deep (≥50%) CSI. The median follow-up time was 75.0 months (range: 5-175 months). Patients in the ≥50% CSI group had a poorer prognosis compared to the <50% CSI group (recurrence-free survival [RFS]: adjusted hazard ratio [aHR] = 6.077, 95% Confidence Interval [CI]: 2.275-16.236, disease-specific survival [DSS]: aHR = 7.259, 95% CI: 2.546-20.695). Deep CSI was an independent predictor of local recurrence (aHR=5.537, 95% CI: 1.804-16.991). Post operative external beam radiation therapy (EBRT) was correlated with a reduced risk of recurrence (aHR = 0.288, 95% CI: 0.097-0.859).ConclusionDeep CSI is a poor prognostic factor for RFS and DSS in patients with FIGO stage II EEC. Postoperative EBRT can improve both RFS and DSS. Those findings imply that a detailed pathological report on the depth of CSI would be helpful in better understanding its impact on prognosis and selecting an appropriate postoperative treatment for the patient.
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spelling doaj-art-05d25e612dc54869a42ee4ed387507122025-08-20T03:11:25ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.14500541450054Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective studyWenyu Shao0Yu Xue1Zhiying Xu2Jun Guan3Huaying Wang4Huaying Wang5Xiaojun Chen6Xiaojun Chen7Yulan Ren8Yulan Ren9Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, ChinaDepartment of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, ChinaDepartment of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, ChinaDepartment of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, ChinaDepartment of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, ChinaDepartment of Gynecology, Tongji University Tenth People’s Hospital, Shanghai, ChinaDepartment of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaObjectiveTo evaluate the impact of depth of cervical stromal invasion (CSI) on the prognosis of International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).MethodsPatients with FIGO stage II EEC confirmed by postoperative histopathology and consecutively admitted to the Obstetrics and Gynecology Hospital of Fudan University and Fudan University Shanghai Cancer Center between 2008 and 2017 were included in this study and reviewed retrospectively.ResultsTwo hundred and ninety-seven patients were included in this study. There were 253 (253/297, 85.2%)patients with superficial (<50%) and 44 (44/297, 14.8%) cases with deep (≥50%) CSI. The median follow-up time was 75.0 months (range: 5-175 months). Patients in the ≥50% CSI group had a poorer prognosis compared to the <50% CSI group (recurrence-free survival [RFS]: adjusted hazard ratio [aHR] = 6.077, 95% Confidence Interval [CI]: 2.275-16.236, disease-specific survival [DSS]: aHR = 7.259, 95% CI: 2.546-20.695). Deep CSI was an independent predictor of local recurrence (aHR=5.537, 95% CI: 1.804-16.991). Post operative external beam radiation therapy (EBRT) was correlated with a reduced risk of recurrence (aHR = 0.288, 95% CI: 0.097-0.859).ConclusionDeep CSI is a poor prognostic factor for RFS and DSS in patients with FIGO stage II EEC. Postoperative EBRT can improve both RFS and DSS. Those findings imply that a detailed pathological report on the depth of CSI would be helpful in better understanding its impact on prognosis and selecting an appropriate postoperative treatment for the patient.https://www.frontiersin.org/articles/10.3389/fonc.2025.1450054/fullendometrial neoplasmsdepth of cervical stromal invasionradiotherapyadjuvantrecurrence free survivaldisease-specific survival
spellingShingle Wenyu Shao
Yu Xue
Zhiying Xu
Jun Guan
Huaying Wang
Huaying Wang
Xiaojun Chen
Xiaojun Chen
Yulan Ren
Yulan Ren
Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
Frontiers in Oncology
endometrial neoplasms
depth of cervical stromal invasion
radiotherapy
adjuvant
recurrence free survival
disease-specific survival
title Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
title_full Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
title_fullStr Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
title_full_unstemmed Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
title_short Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study
title_sort deep cervical stromal invasion predicts poor prognosis in patients with stage ii endometrioid endometrial cancer a two centered retrospective study
topic endometrial neoplasms
depth of cervical stromal invasion
radiotherapy
adjuvant
recurrence free survival
disease-specific survival
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1450054/full
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