Background and aims: To evaluate pattern of failures and prognostic factors in women with Type 2 endometrial cancer (EC) focusing on histological subtype and adjuvant treatment. Methods: Between 1997 and 2009, 80 patients out of 603 consecutive cases of EC (13.2%) had Type 2- EC (41 papillary serous, 21 clear cell, 11 undifferentiated and 7 adenosquamous). Six patients were not eligible for missing data. 74 (100%) patients underwent hysterectomy and BSO, 36 (48.6%) lymphadenectomy. FIGO stages were as follows: I=34 (46.0%), II=12(16.2%), III=24(32.4)%, IV=4(5.4%). 24 patients (32.4%) received no adjuvant treatment, 22(29.7%) chemotherapy, 15 (20.2%) radiotherapy, 13 (17.5%) chemo-radiotherapy as adjuvant treatment. Kaplan Maier method and Log rank test were used to assess survival prognostic factors. Multivariate Cox-proportional hazard model was generated. Results: The 5 year survival rate was: 88.9% in stage I, 75% in stage II, 52% in stage III and 40% in stage IV. No survival difference was found by different histotypes (p=0.274). 15 patients relapsed: 11 (73.3%) had distant site recurrences, 4 (26.6%) loco-regional recurrences irrespective of post surgical management. Stage, LVSI, nodes and omental metastasis, positive peritoneal cytology had prognostic significance at univariate analysis. On multivariate analysis, LVSI (p=0.01), myometrial infiltration (p=0.01) and stage (p< 0.001) were independent prognostic factors. Conclusions: Type 2 endometrial cancer is rare and differs from Type 1 especially for the high frequency of distant metastasis. The pattern of failures supports the use of systemic adjuvant treatment. A multicentric study is needed to better define appropriate management for these kind of malignancies.
PATTERN OF FAILURES AND PROGNOSTIC FACTORS IN TYPE 2 ENDOMETRIAL CARCINOMA: A SINGLE INSTITUTION RETROSPECTIVE STUDY
ZANFAGNIN, Valentina;TRIPODI, Elisa;PIOVANO, ELISA;FERRERO, Anna Maria;ZOLA, Paolo
2010-01-01
Abstract
Background and aims: To evaluate pattern of failures and prognostic factors in women with Type 2 endometrial cancer (EC) focusing on histological subtype and adjuvant treatment. Methods: Between 1997 and 2009, 80 patients out of 603 consecutive cases of EC (13.2%) had Type 2- EC (41 papillary serous, 21 clear cell, 11 undifferentiated and 7 adenosquamous). Six patients were not eligible for missing data. 74 (100%) patients underwent hysterectomy and BSO, 36 (48.6%) lymphadenectomy. FIGO stages were as follows: I=34 (46.0%), II=12(16.2%), III=24(32.4)%, IV=4(5.4%). 24 patients (32.4%) received no adjuvant treatment, 22(29.7%) chemotherapy, 15 (20.2%) radiotherapy, 13 (17.5%) chemo-radiotherapy as adjuvant treatment. Kaplan Maier method and Log rank test were used to assess survival prognostic factors. Multivariate Cox-proportional hazard model was generated. Results: The 5 year survival rate was: 88.9% in stage I, 75% in stage II, 52% in stage III and 40% in stage IV. No survival difference was found by different histotypes (p=0.274). 15 patients relapsed: 11 (73.3%) had distant site recurrences, 4 (26.6%) loco-regional recurrences irrespective of post surgical management. Stage, LVSI, nodes and omental metastasis, positive peritoneal cytology had prognostic significance at univariate analysis. On multivariate analysis, LVSI (p=0.01), myometrial infiltration (p=0.01) and stage (p< 0.001) were independent prognostic factors. Conclusions: Type 2 endometrial cancer is rare and differs from Type 1 especially for the high frequency of distant metastasis. The pattern of failures supports the use of systemic adjuvant treatment. A multicentric study is needed to better define appropriate management for these kind of malignancies.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
