Tags

Type your tag names separated by a space and hit enter

Outcome and management of pathological stage I endometrial carcinoma patients with involvement of the lower uterine segment.

Abstract

OBJECTIVE

The objective was to evaluate the clinicopathologic characteristics and outcome of pathologic stage I endometrial carcinoma patients with lower uterine segment (LUS) involvement.

METHODS

We retrospectively reviewed the characteristics and outcomes of pathologic stage I endometrial carcinoma patients treated with primary surgery at our institution between 1988 and 1998. The significance of LUS involvement was examined with univariate and multivariate analyses. Median patient follow-up was 37.3 months.

RESULTS

Of the 98 cases reviewed, 41 (42%) had LUS involvement. No differences were seen in the clinicopathologic features, extent of surgical staging, or adjuvant therapies between patients with and without LUS involvement. Univariate analysis revealed that grade, lymphovascular invasion (LVI), myometrial invasion (MI), and histology were correlated with recurrence. While the 5-year actuarial disease-free survival was worse in women with LUS involvement (80.3 vs 94.0%) compared to those without, this difference did not reach statistical significance (P = 0.14). Moreover, after controlling for pathologic features in a multivariate model, LUS involvement was not correlated with patient outcome (P = 0.98; hazard rate 0.97; 95% confidence interval 0.24, 4.0). LUS was also not correlated with pelvic recurrence. Of 25 low-risk patients (superficial MI and grade 1-2 disease) with LUS involvement, none recurred in the pelvis following surgery alone. In contrast, pelvic recurrence was common (5/12 or 41.6%) in high-risk patients (deep MI and/or grade 3 tumors) following surgery alone regardless of LUS involvement.

CONCLUSION

LUS involvement is common in pathologic stage I endometrial carcinoma but is not correlated with a worse outcome. Moreover, in the absence of adverse pathologic features, LUS involvement is not associated with an increased risk of pelvic recurrence and should not be used as an indication for adjuvant radiation therapy.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Departments of Obstetrics and Gynecology, University of Chicago Hospitals, Chicago, Illinois 60637, USA.

    , , , ,

    Source

    Gynecologic oncology 83:3 2001 Dec pg 513-7

    MeSH

    Aged
    Endometrial Neoplasms
    Female
    Humans
    Middle Aged
    Neoplasm Recurrence, Local
    Neoplasm Staging
    Retrospective Studies
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    11733964

    Citation

    Phelan, C, et al. "Outcome and Management of Pathological Stage I Endometrial Carcinoma Patients With Involvement of the Lower Uterine Segment." Gynecologic Oncology, vol. 83, no. 3, 2001, pp. 513-7.
    Phelan C, Montag AG, Rotmensch J, et al. Outcome and management of pathological stage I endometrial carcinoma patients with involvement of the lower uterine segment. Gynecol Oncol. 2001;83(3):513-7.
    Phelan, C., Montag, A. G., Rotmensch, J., Waggoner, S. E., Yamada, S. D., & Mundt, A. J. (2001). Outcome and management of pathological stage I endometrial carcinoma patients with involvement of the lower uterine segment. Gynecologic Oncology, 83(3), pp. 513-7.
    Phelan C, et al. Outcome and Management of Pathological Stage I Endometrial Carcinoma Patients With Involvement of the Lower Uterine Segment. Gynecol Oncol. 2001;83(3):513-7. PubMed PMID: 11733964.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Outcome and management of pathological stage I endometrial carcinoma patients with involvement of the lower uterine segment. AU - Phelan,C, AU - Montag,A G, AU - Rotmensch,J, AU - Waggoner,S E, AU - Yamada,S D, AU - Mundt,A J, PY - 2001/12/6/pubmed PY - 2002/1/5/medline PY - 2001/12/6/entrez SP - 513 EP - 7 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 83 IS - 3 N2 - OBJECTIVE: The objective was to evaluate the clinicopathologic characteristics and outcome of pathologic stage I endometrial carcinoma patients with lower uterine segment (LUS) involvement. METHODS: We retrospectively reviewed the characteristics and outcomes of pathologic stage I endometrial carcinoma patients treated with primary surgery at our institution between 1988 and 1998. The significance of LUS involvement was examined with univariate and multivariate analyses. Median patient follow-up was 37.3 months. RESULTS: Of the 98 cases reviewed, 41 (42%) had LUS involvement. No differences were seen in the clinicopathologic features, extent of surgical staging, or adjuvant therapies between patients with and without LUS involvement. Univariate analysis revealed that grade, lymphovascular invasion (LVI), myometrial invasion (MI), and histology were correlated with recurrence. While the 5-year actuarial disease-free survival was worse in women with LUS involvement (80.3 vs 94.0%) compared to those without, this difference did not reach statistical significance (P = 0.14). Moreover, after controlling for pathologic features in a multivariate model, LUS involvement was not correlated with patient outcome (P = 0.98; hazard rate 0.97; 95% confidence interval 0.24, 4.0). LUS was also not correlated with pelvic recurrence. Of 25 low-risk patients (superficial MI and grade 1-2 disease) with LUS involvement, none recurred in the pelvis following surgery alone. In contrast, pelvic recurrence was common (5/12 or 41.6%) in high-risk patients (deep MI and/or grade 3 tumors) following surgery alone regardless of LUS involvement. CONCLUSION: LUS involvement is common in pathologic stage I endometrial carcinoma but is not correlated with a worse outcome. Moreover, in the absence of adverse pathologic features, LUS involvement is not associated with an increased risk of pelvic recurrence and should not be used as an indication for adjuvant radiation therapy. SN - 0090-8258 UR - https://www.unboundmedicine.com/medline/citation/11733964/Outcome_and_management_of_pathological_stage_I_endometrial_carcinoma_patients_with_involvement_of_the_lower_uterine_segment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(01)96407-8 DB - PRIME DP - Unbound Medicine ER -