Re-thinking the prognostic significance of positive peritoneal cytology in endometrial cancer
| Autor: | Hirokuni Takano, Motoaki Saito, Masataka Takenaka, Aikou Okamoto, Jiro Suzuki, Yasushi Iida, Nozomu Yanaihara, Misato Kamii, Satoshi Yanagida, Kyosuke Yamada, Kazuaki Takahashi |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Prognostic factor Multivariate analysis medicine.medical_treatment Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans Stage (cooking) Peritoneal Cavity Survival analysis Neoplasm Staging Hysterectomy Peritoneal cytology business.industry Endometrial cancer Obstetrics and Gynecology Middle Aged medicine.disease Prognosis Endometrial Neoplasms 030104 developmental biology 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | Gynecologic oncology. 161(1) |
| ISSN: | 1095-6859 |
| Popis: | Background Whether abnormal peritoneal cytology (PC) is an independent prognostic factor in endometrial cancer (EC) remains controversial. This study aimed to re-think the prognostic significance of PC in not only all EC patients but also in various subgroups with similar clinicopathological and biological characteristics. Methods EC patients who underwent primary surgery of at least a hysterectomy and were pathologically diagnosed with EC in four hospitals affiliated with the Jikei University School of Medicine were retrospectively reviewed. The prognostic significance of PC was evaluated with univariate and multivariate analyses in the entire cohort and subgroups stratified by surgical stages (early/advanced stages), tumor types (types 1/2), and risk classifications (low/intermediate/high). Results Of 1963 EC cases, 1616 met the inclusion criteria. Positive PC was identified as an adverse prognostic factor in analyses of all EC cases and in all subgroup analyses stratified by surgical stages and tumor types. In survival curve comparisons, the progression-free survival (PFS) and disease-specific survival in early-stage patients with positive PC were clearly located between those of stage II patients with negative PC and stage III patients. In the subgroup analyses stratified by risk classification in early-stage EC, positive PC was related to poorer PFS in the intermediate- and high-risk groups but not in the low-risk group. Conclusion PC status was an independent prognostic factor of EC in all stages and tumor types. Early PC-positive cases, except for the low-risk group, may be recommended for upstaging and should be carefully managed compared with PC-negative cases. |
| Databáze: | OpenAIRE |
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