The Prognostic Significance of the Depth of Cervical Stromal Invasion in Women With FIGO Stage II Uterine Endometrioid Carcinoma.

OBJECTIVE: The objective of this study was to investigate the prognostic significance of the depth of cervical stromal invasion (CSI) in women with FIGO stage II uterine endometrioid adenocarcinoma (EC). METHODS: Our database of women with EC was quired for patients with stage II EC. Pathologic slides were retrieved and reviewed by gynecologic pathologists to determine cervical stromal thickness and depth of CSI as a percentage of stromal thickness (%CSI). Kaplan-Meier, univariate, and multivariate analyses were used to compare recurrence-free, disease-specific (DSS), and overall survival (OS) between women who had<50% versus ≥50% CSI. Univariate and multivariate analyses were used to assess other prognostic variables associated with survival endpoints. RESULTS: A total of 117 patients were included in our study who had hysterectomy between 1/1990 and 8/2021. Seventy-nine patients (68%) with <50% and 38 (32w%) with ≥50% CSI. After a median follow-up of 131 months, 5-year DSS was significantly worse for women with ≥50% CSI (78% vs. 91%; P =0.04). However, %CSI was not an independent predictor for any of the studied survival endpoints. Independent predictors of worse 5-year recurrence-free survival and DSS included FIGO grade 3 tumors ( P =0.02) and the presence of lymphovascular space invasion ( P =0.03). Grade 3 tumors were the only independent predictor of worse 5-year OS ( P =0.02). CONCLUSIONS: Our results suggest that deep CSI is not an independent prognostic factor for survival endpoints in women with stage II uterine endometroid adenocarcinoma. The lack of independent prognostic significance of the depth CSI needs to be validated in a multi-institutional analysis.

Fatness is not a factor of fitness: analysis of cardiorespiratory data from healthy children over an 8-year period.

PURPOSE: To evaluate exercise performance and body mass index in healthy children over an 8-year period in order to determine whether cardiorespiratory fitness has decreased relative to changes in body mass index in our patient population. METHOD: This study is a retrospective review of anthropometric and cardiorespiratory fitness data from our hospital's Exercise Physiology Laboratory's database on 1201 healthy children (6-18 years) with structurally normal hearts who performed one cycle ergometry test between 1999 and 2006. Subjects were stratified by gender and age. Body mass index was compared between 1999-2002 (Early Group) and 2003-2006 (Late Group) and with national averages. Exercise outcome variables were maximal oxygen consumption, anaerobic threshold, physical working capacity indexed to body weight. Analysis of variance was used to detect differences between groups for each outcome variable. RESULTS: Body mass index was not significantly different from national data (p-value equals 0.79) or between groups. A negative trend (p-value greater than 0.15 less than 0.20) was observed among most indices of exercise performance between Early and Late Groups. Significantly lower anaerobic threshold was found among males between Early and Late Group (25.7 plus or minus 0.9 versus 23.4 plus or minus 1.6 millilitres per kilogram per minute, p-value less than 0.01), and in physical working capacity among females between Early and Late Groups (2.9 plus or minus 0.1 versus 2.7 plus or minus 0.1, p-value less than 0.05). CONCLUSIONS: Cardiorespiratory fitness in males and working capacity in females declined over time independent of body mass index. This suggests that other measures may need to be evaluated for promotion of overall cardiovascular health.