Significance of prognostic evaluation of International Federation of Gynecology and Obstetrics 2009 staging system on stage Ⅰ endometrioid adenocarcinoma / 中华妇产科杂志

ABSTRACT

Objective To explore the impact of 2009 International Federation of Gynecology and Obstetrics(FIGO)staging system alteration for stage Ⅰ endometrioid adenocarcinoma on its' prognosis assessing.Methods A retrospective study was carried out on 244 cases with endometrial carcinoma admitted in Peking University People's Hospital from Jan.1995 to Feb.2008.Results(1)All 244 patients were divided into FIGO 2009 Ⅰ a group(n =200)and FIGO 2009 Ⅰ b group(n =44)according to FIGO 2009 staging system,while they were divided into FIGO 1988 Ⅰ a group(n =34),FIGO 1988 Ⅰ b group(n =156)and FIGO 1988 Ⅰ c group(n =29).The others 25 cases were stage Ⅱ a(n =16)and stage Ⅲa with merely positive abdominal cytology(n =9)according to FIGO 1988 staging system.(2)The higher percentage of low-grade in FIGO 1988 Ⅰ a group than that in FIGO 2009 Ⅰ a group(P =0.003).Compared with FIGO 2009 Ⅰ a group,the age of the patients,surgery extent,the percentage of lymph node excision and received chemotherapy and radiotherapy,there were no difference in FIGO 1988 Ⅰ a and Ⅰ b group,respectively(P ＞ 0.05).There were 5.9％(2/34)and 6.7％(10/150)found relapse among FIGO 1988 Ⅰ a group and FIGO 1988 Ⅰ b group,and there were 2.9％(1/34)and 2.7％(4/150)for the two groups died of carcinoma.Compared with FIGO 2009 Ⅰ a group,there were not significant difference[7.5％(13/200)vs.3.0％(6/200);P ＞0.05].The 5 years and 10 years progression-free survival(PFS)of FIGO 1988 Ⅰ a group and Ⅰ b group were(97.0 ±3.0)％,(90.9 ±6.5)％ and(95.3 ±2.1)％,(90.2 ± 3.6)％,respectively,in which there were not significant difference compared with that in FIGO 2009 Ⅰ a group[(96.1 ±1.6)％,(89.6±3.2)％ ; P＞0.05].The 5 years and 10 years overall survival(OS)in FIGO 1988 Ⅰ a group and Ⅰ b group were 100％,(93.8 ±6.0)％ and(96.9 ± 1.8)％,(95.2 ±2.5)％,respectively,in which there were did not significant difference with that in FIGO 2009 Ⅰ a group [(97.9 ± 1.2)％,(93.4 ± 2.8)％ ; P ＞ 0.05].(3)There were not significant difference between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group(P ＞0.05)for the age of the patients,grade,surgery extent,lymph node excision,the percentage of received chemotherapy and radiotherapy.Between FIGO 1988 Ⅰ c group and FIGO 2009 Ⅰ b group,there were 3.4％(1/29)and 6.8％(3/44)cases found relapse,respectively.And there were 0 and 2.3％(1/44)cases died of carcinoma in the two groups,in which there were not differ much either(P ＞ O.05).The 5 years and 10 years PFS in FIGO 1988 Ⅰ c group were all 100％,while they were 100％ and(90.9 ±6.2)％ in FIGO 2009 Ⅰ b group.The 5 years and 10 years OS in FIGO 1988 Ⅰ c group were all 100％,but were 100％ and(95.0 ±4.9)％ in FIGO 2009 Ⅰ b group,in which they all did not significantly differ much(P ＞ 0.05).(4)The patients in FIGO 2009 Ⅰ a group were younger than those in FIGO 2009 Ⅰ b group(P ＜ 0.01).The percentage of low grade in FIGO 2009 Ⅰ a group were higher than that in FIGO 2009 Ⅰ b group(P =0.029).The percentages of received chemotherapy and radiotherapy in FIGO 2009 Ⅰ a group were lower than that in FIGO 2009 Ⅰ b group remarkably(P ＜ 0.01).But there were not significant difference in the uterine excision extent and the percentage of lymph node excision between the two groups(P ＞ 0.05).There were not significantly differ in the relapse rates and the death rates between the FIGO 2009 Ⅰ a group and FIGO 2009 Ⅰ b group(P ＞0.05).There were also not significant difference in PFS and OS between the two groups(P ＞0.05).Conclusions There were not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 1988 stage Ⅰ a and Ⅰ b.There were also not significant difference in the prognosis between FIGO 2009 stage Ⅰ a and FIGO 2009 stage Ⅰ b,which may be due to received more chemotherapy and radiotherapy in FIGO 2009 stage Ⅰ b patients.