Associated characteristics and impact on recurrence and survival of free-floating tumor fragments in the lumen of fallopian tubes in Type I and Type II endometrial cancer

Autor: Benjamin B. Albright, Jonathan D. Black, Rachel Passarelli, Stefan Gysler, Margaret Whicker, Gary Altwerger, Gulden Menderes, Natalia Buza, Pei Hui, Alessandro D. Santin, Masoud Azodi, Dan-Arin Silasi, Elena S. Ratner, Babak Litkouhi, Peter E. Schwartz
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Gynecologic Oncology Reports, Vol 23, Iss C, Pp 28-33 (2018)
Druh dokumentu: article
ISSN: 2352-5789
DOI: 10.1016/j.gore.2018.01.003
Popis: Objective: This study sought to evaluate characteristics of cases of free-floating tumor fragments within the lumen of fallopian tubes (‘floaters’) on final pathology for Type I and Type II endometrial adenocarcinoma, including relationships with disease recurrence and mortality. Methods: A single institution experience of 1022 consecutive cases of uterine cancer presenting between 2005 and 2010 was retrospectively reviewed, with data extraction from electronic medical records. Associations of floaters with baseline characteristics were studied with logistic regression, and relationships with disease recurrence and survival were assessed with Cox proportional hazards models. Results: Among 816 included cases of Type I or Type II endometrial adenocarcinoma, floaters were identified on final pathology for 20 patients (2.5%). Patient characteristics of cases with floaters mirrored the overall sample. With adjustment, presence of floaters trended towards association with laparoscopic/robotic approach (OR = 3.84; 95%CI 0.98-15.1), and was significantly associated with lymphovascular invasion (OR = 9.65; 95%CI 2.35-39.6) and higher stage disease. Although floaters were associated with increased risk of recurrence in unadjusted analysis (HR = 3.22; 95%CI 1.41-7.37), after adjustment for disease type, stage, and patient comorbidities, no evidence for impact on disease recurrence or overall survival was found. Conclusions: The presence of floaters is rare. Floaters were generally associated with more extensive disease, but no evidence was found to show any independent prognostic impact on risk of recurrence or death. In agreement with prior research, this study found a trend towards association of floaters with laparoscopic/robotic approach, indicating the possibility of floaters sometimes being the result of trauma from uterine manipulator insertion.
Databáze: Directory of Open Access Journals