LymphedemaV1, Main, Exploration, bibRecord, 001C74

Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer

Identifieur interne : 001C74 ( Main/Exploration ); précédent : 001C73; suivant : 001C75

Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer

Auteurs : Nicole D. Fleming [États-Unis] ; Pamela T. Soliman [États-Unis] ; Shannon N. Westin [États-Unis] ; Ricardo Dos Reis [Brésil] ; Mark Munsell [États-Unis] ; Ann H. Klopp [États-Unis] ; Michael Frumovitz [États-Unis] ; Alpa M. Nick [États-Unis] ; Kathleen Schmeler [États-Unis] ; Pedro T. Ramirez [États-Unis]

Source :

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [ 1048-891X ] ; 2015.

RBID : PMC:4581897

Abstract

Objectives

To determine if the ratio of positive to negative lymph nodes, or lymph node ratio (LNR), is a prognostic variable in patients with node-positive endometrial cancer and the impact of adjuvant therapy on survival.

Methods

After IRB approval, a retrospective review of patients diagnosed with stage IIIC endometrioid or mixed endometrioid endometrial cancer at a single institution from January 2000 through October 2011 was performed. Clinicopathologic and adjuvant treatment data was collected. Univariate and multivariate analysis were used to identify prognostic factors for progression-free (PFS) and overall survival (OS).

Results

One hundred twenty-four patients with stage IIIC1 (n=64) and IIIC2 (n=60) endometrial cancer were included in the analysis. Median age was 60 years (range 25-84) and median follow-up was 49.4 months (range 0.1-301.6). Age >70 years was identified as a prognostic factor for worse PFS (p=0.0002) and OS (p=0.0002) on multivariate analysis. Patients in this cohort receiving any adjuvant radiotherapy showed improved PFS (HR 0.34, 95% CI 0.13-0.90, p=0.03) compared to those receiving any adjuvant chemotherapy (HR 2.33, 95% CI 1.16-4.65, p=0.02). In a subgroup analysis, patients with ≥ 10 nodes removed (n=81) with a LNR >50% had a PFS of 25.2 months compared to 135.6 months with a LNR ≤50% (HR 3.87, 95% CI 1.15-13.04, p=0.03).

Conclusions

LNR may define a subgroup of stage IIIC endometrial cancers at increased risk for recurrence. Adjuvant radiotherapy was associated with decreased recurrence risk.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581897

DOI: 10.1097/IGC.0000000000000510
PubMed: 26332387
PubMed Central: 4581897

Affiliations:

Le document en format XML

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</affiliation>
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<author><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<affiliation wicri:level="2"><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston</wicri:cityArea>
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<author><name sortKey="Nick, Alpa M" sort="Nick, Alpa M" uniqKey="Nick A" first="Alpa M." last="Nick">Alpa M. Nick</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
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<wicri:cityArea>Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston</wicri:cityArea>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston</wicri:cityArea>
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<author><name sortKey="Ramirez, Pedro T" sort="Ramirez, Pedro T" uniqKey="Ramirez P" first="Pedro T." last="Ramirez">Pedro T. Ramirez</name>
<affiliation wicri:level="2"><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston</wicri:cityArea>
</affiliation>
</author>
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<series><title level="j">International journal of gynecological cancer : official journal of the International Gynecological Cancer Society</title>
<idno type="ISSN">1048-891X</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">To determine if the ratio of positive to negative lymph nodes, or lymph node ratio (LNR), is a prognostic variable in patients with node-positive endometrial cancer and the impact of adjuvant therapy on survival.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">After IRB approval, a retrospective review of patients diagnosed with stage IIIC endometrioid or mixed endometrioid endometrial cancer at a single institution from January 2000 through October 2011 was performed. Clinicopathologic and adjuvant treatment data was collected. Univariate and multivariate analysis were used to identify prognostic factors for progression-free (PFS) and overall survival (OS).</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">One hundred twenty-four patients with stage IIIC1 (n=64) and IIIC2 (n=60) endometrial cancer were included in the analysis. Median age was 60 years (range 25-84) and median follow-up was 49.4 months (range 0.1-301.6). Age >70 years was identified as a prognostic factor for worse PFS (p=0.0002) and OS (p=0.0002) on multivariate analysis. Patients in this cohort receiving any adjuvant radiotherapy showed improved PFS (HR 0.34, 95% CI 0.13-0.90, p=0.03) compared to those receiving any adjuvant chemotherapy (HR 2.33, 95% CI 1.16-4.65, p=0.02). In a subgroup analysis, patients with ≥ 10 nodes removed (n=81) with a LNR >50% had a PFS of 25.2 months compared to 135.6 months with a LNR ≤50% (HR 3.87, 95% CI 1.15-13.04, p=0.03).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">LNR may define a subgroup of stage IIIC endometrial cancers at increased risk for recurrence. Adjuvant radiotherapy was associated with decreased recurrence risk.</p>
</sec>
</div>
</front>
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<name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<name sortKey="Klopp, Ann H" sort="Klopp, Ann H" uniqKey="Klopp A" first="Ann H." last="Klopp">Ann H. Klopp</name>
<name sortKey="Munsell, Mark" sort="Munsell, Mark" uniqKey="Munsell M" first="Mark" last="Munsell">Mark Munsell</name>
<name sortKey="Nick, Alpa M" sort="Nick, Alpa M" uniqKey="Nick A" first="Alpa M." last="Nick">Alpa M. Nick</name>
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<name sortKey="Schmeler, Kathleen" sort="Schmeler, Kathleen" uniqKey="Schmeler K" first="Kathleen" last="Schmeler">Kathleen Schmeler</name>
<name sortKey="Soliman, Pamela T" sort="Soliman, Pamela T" uniqKey="Soliman P" first="Pamela T." last="Soliman">Pamela T. Soliman</name>
<name sortKey="Westin, Shannon N" sort="Westin, Shannon N" uniqKey="Westin S" first="Shannon N." last="Westin">Shannon N. Westin</name>
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<country name="Brésil"><region name="État de São Paulo"><name sortKey="Dos Reis, Ricardo" sort="Dos Reis, Ricardo" uniqKey="Dos Reis R" first="Ricardo" last="Dos Reis">Ricardo Dos Reis</name>
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Serveur d'exploration sur le lymphœdème

Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer

Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer

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Abstract

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