Predictors of recurrence and prognosis in patients with stage Ⅰ and Ⅱ endometrial carcinoma / 中华妇产科杂志

ABSTRACT

Objective To explore the high-risk clinicopathological features for the recurrence and prognosis of endometrial carcinoma diagnosed as International Federation of Gynecology and Obstetrics (FIGO) stages Ⅰ and Ⅱ.Methods Three hundreds ninety-eight consecutive patients with clinical stage I,Ⅱ endometrial adenocarcinoma underwent primary surgical therapy between Oct.1990 to Oct.2010 were studied retrospectively to analyze the correlation between clinicopathological risk factors and the disease recurrence or prognosis.Results Thirty-six patients (9.0％,36/398) developed recurrence,21 of them (58.3％,21/36) relapsed within 5 years of treatment.The results shown that the disease recurrence were significantly associated with clinicopathological factors includingage [≤50 years versus ＞ 50 years,1.9％ (2/103) versus 11.5％ (34/295) ; P =0.004] ; histologic types [adenocarcinoma versus serous papillary adenocarcinoma,8.0％ (27/338) versus 6/14; P =0.000] ; tumor grade [grade 1,2 (7.4％,25/338) versus grade 3 (17.9％,10/56) ;P =0.022] ; depth of myometrial invasion [none (3.4％,2/59) versus ＜ 1/2 (7.5 ％,18/240) versus ≥ 1/2 (16.2％,16/99) ; P =0.011] ; tumor size [≤ 2 cm (5.9％,17/287) versus ＞ 2 cm (17.1％,19/111) ; P =0.000].peritoneal cytology [negative (6.9％,22/317) versus positive (23.8％,5/21) ;P =0.019] ;ER status[negative (20.8％,11/53) versus positive (5.5％,16/293) ; P =0.000] ; PR status [negative (30.0％,15/50) versus positive (4.1％,12/295) ; P =0.031].But lympho vascular space invasion (LVSI),p53 or PTEN status were not significant effect on recurrence and prognosis.Univariate analysis of survival indicated that age,histology,tumor grade,depth of myometrial invasion,tumor size,peritoneal cytology and PR status were correlated with overall survival(OS) and disease free survival (DFS ; all P ＜ 0.05),while ER status only impact on DFS (P ＜ 0.05).Conclusions The results showed that age,histologic type of carcinoma,myometrial invasion,tumor grade,peritoneal cytology,tumor size,ER and PR status are significant predictors for recurrence and prognosis of FIGO Ⅰ,Ⅱ stage endometrial carcinoma.Regular follow-up after treatment is essential for patients within 5 years.