Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer

Objective: We sought to re-explore the association between well-known prognostic factors and recurrence in presumed early-stage low-risk endometrial cancer (EC). Methods: A retrospective cohort study was carried out on patients who underwent surgical treatment by the same surgeon for presumed early-...

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Main Authors: Thales Paulo Batista, Rafael Palmeira Santana, Camilla Maria Guimarães Augusto, Nivaldo Sobral Morais, Maria Lídia Amaral Barbosa Ventura, Artur Lício Rocha Bezerra
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2022-10-01
Series:Brazilian Journal of Oncology
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Online Access:https://www.brazilianjournalofoncology.com.br/details/180/en-US/reviewing-prognostic-factors-associated-with-recurrence-in-clinically-early-stage-low-risk-endometrial-cancer
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author Thales Paulo Batista
Rafael Palmeira Santana
Camilla Maria Guimarães Augusto
Nivaldo Sobral Morais
Maria Lídia Amaral Barbosa Ventura
Artur Lício Rocha Bezerra
author_facet Thales Paulo Batista
Rafael Palmeira Santana
Camilla Maria Guimarães Augusto
Nivaldo Sobral Morais
Maria Lídia Amaral Barbosa Ventura
Artur Lício Rocha Bezerra
author_sort Thales Paulo Batista
collection DOAJ
description Objective: We sought to re-explore the association between well-known prognostic factors and recurrence in presumed early-stage low-risk endometrial cancer (EC). Methods: A retrospective cohort study was carried out on patients who underwent surgical treatment by the same surgeon for presumed early-stage low-risk EC between September 2003 to August 2017. The prognostic value of well-known clinicopathological factors for diseasefree survival (DFS) was reviewed by univariate log-rank test. Results: One hundred and five patients fit the criteria for this analysis. These patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with no lymph nodes dissection (10.5%) or with a sampling dissection alone (89.5%). Adjuvant therapies were applied in 52 (40.1%) of them as pelvic radiotherapy (29.5%) or chemoradiation (11.4%). Our cumulative 3y-DFS and OS were 88.1% and 97.7%, respectively. The univariate survival analysis confirmed histological grade 3 (3y-DFS of 89.9% vs. 33.3%, p=0.004), MMI ≥50% (3y-DFS of 95.2% vs. 71.3%, p=0.003), lymph node metastasis (3y-DFS of 88.3% vs. 60%; p=0.028) and more advanced pathological stages (3y-DFS of 91.2% vs. 56.3; p<0.001) as significantly associated to recurrences. Conclusion: We confirmed the association of classical prognostic factors such as high histological grade, deeper MMI, lymph node metastasis and more advanced pathological stages with disease recurrence in this cohort of patients from Northeast Brazil. Further efforts are needed to avoid overtreatment in patients with low risk of relapses.
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spelling doaj-art-4f8236decc7249568c996d334ed486d82025-08-20T02:05:39ZengThieme Revinter Publicações Ltda.Brazilian Journal of Oncology2526-87322022-10-01180010.5935/2526-8732.20220244Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancerThales Paulo Batista0https://orcid.org/0000-0001-5320-3205Rafael Palmeira Santana1Camilla Maria Guimarães Augusto2Nivaldo Sobral Morais3Maria Lídia Amaral Barbosa Ventura4Artur Lício Rocha Bezerra5Instituto de Medicina Integral professor Fernando Figueira (IMIP), Department of Surgery/Oncology - Recife - Pernambuco - BrazilInstituto de Medicina Integral professor Fernando Figueira (IMIP), Faculdade Pernambucana de Saúde - Recife - Pernambuco - BrazilInstituto de Medicina Integral professor Fernando Figueira (IMIP), Faculdade Pernambucana de Saúde - Recife - Pernambuco - BrazilInstituto de Medicina Integral professor Fernando Figueira (IMIP), Faculdade Pernambucana de Saúde - Recife - Pernambuco - BrazilInstituto de Medicina Integral professor Fernando Figueira (IMIP), Faculdade Pernambucana de Saúde - Recife - Pernambuco - BrazilInstituto de Medicina Integral professor Fernando Figueira (IMIP), Faculdade Pernambucana de Saúde - Recife - Pernambuco - BrazilObjective: We sought to re-explore the association between well-known prognostic factors and recurrence in presumed early-stage low-risk endometrial cancer (EC). Methods: A retrospective cohort study was carried out on patients who underwent surgical treatment by the same surgeon for presumed early-stage low-risk EC between September 2003 to August 2017. The prognostic value of well-known clinicopathological factors for diseasefree survival (DFS) was reviewed by univariate log-rank test. Results: One hundred and five patients fit the criteria for this analysis. These patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with no lymph nodes dissection (10.5%) or with a sampling dissection alone (89.5%). Adjuvant therapies were applied in 52 (40.1%) of them as pelvic radiotherapy (29.5%) or chemoradiation (11.4%). Our cumulative 3y-DFS and OS were 88.1% and 97.7%, respectively. The univariate survival analysis confirmed histological grade 3 (3y-DFS of 89.9% vs. 33.3%, p=0.004), MMI ≥50% (3y-DFS of 95.2% vs. 71.3%, p=0.003), lymph node metastasis (3y-DFS of 88.3% vs. 60%; p=0.028) and more advanced pathological stages (3y-DFS of 91.2% vs. 56.3; p<0.001) as significantly associated to recurrences. Conclusion: We confirmed the association of classical prognostic factors such as high histological grade, deeper MMI, lymph node metastasis and more advanced pathological stages with disease recurrence in this cohort of patients from Northeast Brazil. Further efforts are needed to avoid overtreatment in patients with low risk of relapses.https://www.brazilianjournalofoncology.com.br/details/180/en-US/reviewing-prognostic-factors-associated-with-recurrence-in-clinically-early-stage-low-risk-endometrial-cancerendometrial neoplasmprognosissurvival analysisdisease-free survivallocoregional neoplasm recurrences
spellingShingle Thales Paulo Batista
Rafael Palmeira Santana
Camilla Maria Guimarães Augusto
Nivaldo Sobral Morais
Maria Lídia Amaral Barbosa Ventura
Artur Lício Rocha Bezerra
Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
Brazilian Journal of Oncology
endometrial neoplasm
prognosis
survival analysis
disease-free survival
locoregional neoplasm recurrences
title Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
title_full Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
title_fullStr Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
title_full_unstemmed Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
title_short Reviewing prognostic factors associated with recurrence in clinically early-stage low-risk endometrial cancer
title_sort reviewing prognostic factors associated with recurrence in clinically early stage low risk endometrial cancer
topic endometrial neoplasm
prognosis
survival analysis
disease-free survival
locoregional neoplasm recurrences
url https://www.brazilianjournalofoncology.com.br/details/180/en-US/reviewing-prognostic-factors-associated-with-recurrence-in-clinically-early-stage-low-risk-endometrial-cancer
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