Clinicopathologic Characteristics and Prognostic Factors of Stage I and II Endometrial cancer of the uterus: A Study of 59 Cases / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to evaluate the clinicopathologic findings, treatment, and prognostic factors of uterine endometrial cancer. METHODS: We retrospectively reviewed 59 patients with histologically proven stage I and II endometrial cancer between January 1994 and December 2004, for clinical profiles and survival. The survival of patients was determined by description of last follow up date in medical records or phone calls. RESULTS: The median age at the time of diagnosis was 51 years (range: 30-71 years) and the most common presenting symptom was vaginal bleeding (83.0%). Endometrioid adenocarcinoma was the most common (96.6%) histologic type of all cases. Forty-nine patients (83.0%) were FIGO stage I and 10 patients were stage II (17.0%), and the histological grades of the tumors were 23 (39.0%) grade 1, 17 (28.8%) grade 2, 7 (11.9%) grade 3, and 12 (20.3%) unknown, respectively. All patients were treated by surgery as primary treatment and given postoperative adjuvant therapy including radiation therapy (32.2%), concurrent chemotherapy and radiation therapy (6.8%), and chemotherapy (3.4%). The 5-year disease free survival rate (DFSR) of stage I and stage II were 92.7% and 66.7%, respectively. The age (> or =60) and menopausal status were significant prognostic factors by univariate anlaysis (p=0.0077; p=0.0149, respectively). However, parity, FIGO surgical stage, histological grade, myometrial invasion, and lymph-vascular space invasion were not significant prognostic factors (p>0.05). CONCLUSION: The age (> or =60) and menopause state were significant prognostic factors of stage I and II uterine endometrial cancer affecting survival of the patients.

An Analysis of Clinicopathologic Prognostic Factors Affecting Survival in Patients with Uterine Endometrial Cancer / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the clinicopathologic characteristics and prognostic factors of uterine endometrial cancer affecting survival of the patients. METHODS: Form Jan. 1995 to Dec. 2001, medical records including operation record and pathologic reports of 111 patients with histologically proven endometrial cancer at Samsung Medical Center were reviewed. The survival of patients was determined by description of last follow up date in medical records or phone calls. RESULTS: The median age of all patients was 52 years and the most common presenting symptom was abnormal vaginal bleeding (74.0%). Histologic type of endometrioid adenocarcinoma was the most common (90%) type of all endometrial cancers. The grades were classified into G1 (65.7%), G2 (17.1%), G3 (12.6%) and unknown (4.5%). The FIGO surgical stage was also classified into stage I(75.7%), stage II (14.4%), stage III (9.0%), and stage IV (0.9%). All patients were treated by primary surgery and postoperative adjuvant therapy including radiation therapy (54.1%), chemotherapy (4.5%) was applied. The overall 5-year disease free survival rate (DFSR) was 86.5% and overall 5-year survival rate was 87.8%. The age (p=0.04), grade (p=0.04), myometrial invasion (p=0.047), FIGO surgical stage (p=0.0067), lymph node metastasis (p=0.0001), lymphovascular space invasion (p=0.01) and C-erb B2 (p=0.04) were significant prognostic factors by univariate analysis. CONCLUSION: The age, grade, myometrial invasion, FIGO surgical stage, lymph node metastasis, lymphovascular space invasion and C-erb B2 were significant prognostic factors of uterine endometrial cancer affecting survival of the patients.

Analysis of 1058 Patients with Uterine Cervical Cancer / 대한산부인과학회잡지

OBJECTIVES: This study was undertaken to analyze the demographic profile and to identify the clinicopathologic prognostic factors affecting survival rate in patients with cervical cancer. METHODS: Records of 1058 patients with cervical cancer treated in Asan Medical Center(AMC) from June 1989 to March 1999 were reviewed. All patients were diagnosed and treated initially in AMC, and the patients who transferred after initial treatment from other hospital or who visited AMC after recurrence were excluded. Demographic profile, findings in preoperative work-up, treatment modality, and post-treatment clinical course were evaluated. Of the 1058 patients, 863 patients were primarily treated with surgery, and their operation records were reviewed. 5-year disease free survival rate(DFSR) was calculated according to histopathologic risk factors such as clinical stage, clinical tumor size, depth of cervical wall invasion, histologic type, LN involvement, lympho-vascular space invasion(LVSI), and involvement of resection margin. And their clinical significance as prognostic factors were assessed using multivariate analysis. RESULS & CONCLUSION: The age at diagnosis ranged from 22 to 85 years old, and the mean age was 50.5 years(SD: 12.5). Of the 1058 patients, the number of patients with FIGO stage I disease were 665(62.8%), those with stage II were 318(30.1%), and those with stage III and stage IV were 58(5.5%) and 17(1.6%), respectively. According to pathologic report, 88.1% of the patients had squamous cell carcinoma, 4.8% had adenosquamous cell carcinoma, 4.1% had adenocarcinoma, 1.3% had undifferentiated malignancy, and 1.7% had the other histologic type of malignancy. Of surgically treated 863 patients, LN involvement was present in 8.6% of patients with stage Ia, 15.1% with Ib, 25.0% with IIa and 26.5% with IIb. External iliac LN was the most frequently involved among regional pelvic LN. Bladder dysfunction was the most common complication after surgery, occupying 11.4%. Other surgical complications included lymphocyst formation(8.9%), fistula formation(2.0%), wound disruption(1.8%), intestinal injury(1.1%), vessel injury(0.8%), and ureteral injury(0.5%). 5-year DFSR according to FIGO stage was as follows: Ia 95.7%, Ib 88.9%, IIa 81.8%, IIb 61.8%, III 45.0%, and IV 25.0%. While FIGO stage, histologic type, LN involvement, and involvement of resection margin had prognostic significance in multivariate analysis, clinical tumor size, depth of cervical wall invasion, and LVSI did not.