LymphedemaV1, Pmc, Corpus, bibRecord, 003906

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

Identifieur interne : 003906 ( Pmc/Corpus ); précédent : 003905; suivant : 003907

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

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

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

Links to Exploration step

PMC:4581897

Le document en format XML

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<author><name sortKey="Fleming, Nicole D" sort="Fleming, Nicole D" uniqKey="Fleming N" first="Nicole D." last="Fleming">Nicole D. Fleming</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Soliman, Pamela T" sort="Soliman, Pamela T" uniqKey="Soliman P" first="Pamela T." last="Soliman">Pamela T. Soliman</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Westin, Shannon N" sort="Westin, Shannon N" uniqKey="Westin S" first="Shannon N." last="Westin">Shannon N. Westin</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dos Reis, Ricardo" sort="Dos Reis, Ricardo" uniqKey="Dos Reis R" first="Ricardo" last="Dos Reis">Ricardo Dos Reis</name>
<affiliation><nlm:aff id="A2">Department of Gynecologic Oncology, Hospital de Cancer de Barretos, Sao Paulo, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Munsell, Mark" sort="Munsell, Mark" uniqKey="Munsell M" first="Mark" last="Munsell">Mark Munsell</name>
<affiliation><nlm:aff id="A3">Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Klopp, Ann H" sort="Klopp, Ann H" uniqKey="Klopp A" first="Ann H." last="Klopp">Ann H. Klopp</name>
<affiliation><nlm:aff id="A4">Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
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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>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schmeler, Kathleen" sort="Schmeler, Kathleen" uniqKey="Schmeler K" first="Kathleen" last="Schmeler">Kathleen Schmeler</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ramirez, Pedro T" sort="Ramirez, Pedro T" uniqKey="Ramirez P" first="Pedro T." last="Ramirez">Pedro T. Ramirez</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer</title>
<author><name sortKey="Fleming, Nicole D" sort="Fleming, Nicole D" uniqKey="Fleming N" first="Nicole D." last="Fleming">Nicole D. Fleming</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Soliman, Pamela T" sort="Soliman, Pamela T" uniqKey="Soliman P" first="Pamela T." last="Soliman">Pamela T. Soliman</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Westin, Shannon N" sort="Westin, Shannon N" uniqKey="Westin S" first="Shannon N." last="Westin">Shannon N. Westin</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dos Reis, Ricardo" sort="Dos Reis, Ricardo" uniqKey="Dos Reis R" first="Ricardo" last="Dos Reis">Ricardo Dos Reis</name>
<affiliation><nlm:aff id="A2">Department of Gynecologic Oncology, Hospital de Cancer de Barretos, Sao Paulo, Brazil</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Munsell, Mark" sort="Munsell, Mark" uniqKey="Munsell M" first="Mark" last="Munsell">Mark Munsell</name>
<affiliation><nlm:aff id="A3">Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Klopp, Ann H" sort="Klopp, Ann H" uniqKey="Klopp A" first="Ann H." last="Klopp">Ann H. Klopp</name>
<affiliation><nlm:aff id="A4">Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nick, Alpa M" sort="Nick, Alpa M" uniqKey="Nick A" first="Alpa M." last="Nick">Alpa M. Nick</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schmeler, Kathleen" sort="Schmeler, Kathleen" uniqKey="Schmeler K" first="Kathleen" last="Schmeler">Kathleen Schmeler</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ramirez, Pedro T" sort="Ramirez, Pedro T" uniqKey="Ramirez P" first="Pedro T." last="Ramirez">Pedro T. Ramirez</name>
<affiliation><nlm:aff id="A1">Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">International journal of gynecological cancer : official journal of the International Gynecological Cancer Society</title>
<idno type="ISSN">1048-891X</idno>
<idno type="eISSN">1525-1438</idno>
<imprint><date when="2015">2015</date>
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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>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">9111626</journal-id>
<journal-id journal-id-type="pubmed-jr-id">22047</journal-id>
<journal-id journal-id-type="nlm-ta">Int J Gynecol Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">Int. J. Gynecol. Cancer</journal-id>
<journal-title-group><journal-title>International journal of gynecological cancer : official journal of the International Gynecological Cancer Society</journal-title>
</journal-title-group>
<issn pub-type="ppub">1048-891X</issn>
<issn pub-type="epub">1525-1438</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26332387</article-id>
<article-id pub-id-type="pmc">4581897</article-id>
<article-id pub-id-type="doi">10.1097/IGC.0000000000000510</article-id>
<article-id pub-id-type="manuscript">NIHMS693391</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Impact of lymph node ratio and adjuvant therapy in node-positive endometrioid endometrial cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Fleming</surname>
<given-names>Nicole D.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Soliman</surname>
<given-names>Pamela T.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Westin</surname>
<given-names>Shannon N.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>dos Reis</surname>
<given-names>Ricardo</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Munsell</surname>
<given-names>Mark</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Klopp</surname>
<given-names>Ann H.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Frumovitz</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nick</surname>
<given-names>Alpa M.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schmeler</surname>
<given-names>Kathleen</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ramirez</surname>
<given-names>Pedro T.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</aff>
<aff id="A2"><label>2</label>
Department of Gynecologic Oncology, Hospital de Cancer de Barretos, Sao Paulo, Brazil</aff>
<aff id="A3"><label>3</label>
Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</aff>
<aff id="A4"><label>4</label>
Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030</aff>
<author-notes><corresp id="FN1">Please send correspondence to: Nicole D. Fleming, MD, 1155 Pressler Drive, Unit 1362, Houston, TX 77030, Phone: (713) 563-1792, Fax: (713) 792-7586, <email>nfleming@mdanderson.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>26</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>25</volume>
<issue>8</issue>
<fpage>1437</fpage>
<lpage>1444</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/IGC.0000000000000510</pmc-comment>
      <abstract><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>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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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

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki