2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer: oncologic outcomes based on involvement of adnexa, serosa, or both.

Autor:	Rios-Doria E; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA., Abu-Rustum NR; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York, USA., Glaser G; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA., McGree M; Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA., Eriksson AG; Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo, Norway.; Faculty of Clinical Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Pham M; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Soliman P; Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Ataseven B; Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany.; Department of Gynecology, Gynecologic Oncology and Obstetrics, Bielefeld University, Medical School and University Medical Center OWL, Klinikum Lippe, Detmold, Germany., Alektiar K; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Zamarin D; Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Leitao ML Jr; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York, USA., Mueller J; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA muellerj@mskcc.org.; Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Oct 07; Vol. 34 (10), pp. 1580-1587. Date of Electronic Publication: 2024 Oct 07.
DOI:	10.1136/ijgc-2024-005567
Abstrakt:	Objective: To assess clinicopathologic features and survival outcomes of patients with endometrial carcinoma involving adnexal, full-thickness serosal, or combined involvement. Methods: This international, multi-institutional, retrospective study examined patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer and tumors involving the uterine serosa and/or adnexa, who were surgically staged between 2000 and 2019. Patients with sarcoma histology, concurrent endometrial/ovarian malignancy, neoadjuvant treatment, positive lymph nodes, or peritoneal disease were excluded. Results: Of 185 patients identified, 139 had tumors with adnexal-only, 40 with serosal-only, and six with combined adnexal/serosal involvement. Median age at diagnosis was 60 years (range 23-89). Among tumors of endometrioid histology, 12 (48%) with serosal-only and 17 (19%) with adnexal-only involvement were FIGO grade 3 (p=0.007). Twenty-three tumors with serosal-only (64%) and 50 with adnexal-only (37%) involvement had lymphovascular invasion (p=0.004). Non-endometrioid histology was present in five tumors (83%) with combined adnexal/serosal, 15 (38%) with serosal-only, and 50 (36%) with adnexal-only involvement.Median follow-up was 77 months (range 0.6-254). Five-year progression-free survival and overall survival rates for all patients with stage IIIA disease were 73.8% (SE 3.5%) and 81.0% (SE 3.1%), respectively. For patients with adnexal-only, serosal-only, and combined adnexal/serosal involvement, 5-year progression-free survival rates were 80% (SE 3.8%), 61% (SE 8.3%), and 33% (SE 19.2%), respectively (p<0.01); 5-year overall survival rates were 85% (SE 3.3%), 70% (SE 7.8%), and 60% (SE 21.9%), respectively (p=0.09). On univariate analysis, tumors having serosal involvement with/without adnexal involvement, non-endometrioid histology, and lymphovascular invasion were significantly associated with progression. On multivariate analysis, tumors having serosal involvement with/without adnexal involvement remained significantly associated with recurrence (adjusted HR=2.2, 95% CI 1.2 to 4.3; p=0.01). Conclusions: Patients with 2009 FIGO stage IIIA endometrial cancer have distinct survival outcomes depending upon adnexal and/or serosal involvement. Progression-free survival was worse for patients with serosal involvement after adjusting for histology, adjuvant treatment, and lymphovascular space invasion. Competing Interests: Competing interests: ML reports personal fees from Medtronic, Intuitive Surgical, J&J/Ethicon, and Immunogen. NRA-R reports research funding paid to the institution from GRAIL. AGE reports speaker fees from Intuitive Surgical and AstraZeneca. DZ reports institutional research support from AstraZeneca, Merck, Plexxikon, Synthekine, and Genentech; consulting fees from AstraZeneca, Synthekine, Astellas, Tessa Therapeutics, Memgen, Celldex, Crown Biosciences, Hookipa Biotech, Kalivir, Xencor, and GSK; royalties from Merck; and stock options from Accurius Therapeutics, ImmunOS Therapeutics, and Calidi Biotherapeutics, all outside the submitted work. The other authors do not have potential conflicts of interest to declare. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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