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LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi

Year 2019, Volume: 50 Issue: 3, 112 - 116, 15.09.2019
https://doi.org/10.16948/zktipb.585846

Abstract

Giriş: Endometrial kanserinde, nüks riski olan
hastaları belirlemek ve adjuvan tedavi kullanımına rehberlik etmek amacı ile
klinik-patolojik prognostik faktörler kullanılarak risk grupları
oluşturulmuştur. Güncel yayınlanan rehberde yeni bir risk grubu tanımlanmış
olup evre I endometrioid karsinom, grade 1-2 hastalık ve LVSI pozitif olan
olgular myometrial invazyon derinliğinden bağımsız olarak “orta-yüksek” riskli
olarak sınıflandırılmıştır. Bu retrospektif çalışmanın amacı evre IA
yüksek-orta riskli endometrial kanserli kadınların prognozlarını evre IB
Yüksek-orta riskli endometrial kanserli kadınlarla karşılaştırmaktır.

Metot: Retrospektif tek merkezli olarak planlanan
çalışmada, 2008-2018 tarihleri arasında endometrium kanseri tanısı ile primer
tedavi olarak cerrahi ile tedavi edilen tüm hastalar incelendi. Çalışmaya evre
I endometroid tip endometrium kanseri olup, LVSI pozitif ve grade 1-2 tümörü
olan toplam 46 olgu dahil edildi. Çalışmaya dahil edilen 17 olgu evre IA ve 29
olgu evre IB olmak üzere gruplandırıldı. Olgular için sağ kalım analizleri
Kaplan Meier metodu kullanılarak hesaplandı.   

Bulgular: 5-yıllık DFS oranı evre
IA olgular için %94,1 ve evre IB olgular için % 82,3 (p=0.951),5- yıllık OS
oranı evre IA olgular için % 94,1 ve evre IB olgular için % 89 (p=0.811) olarak
belirlenmiştir. 







Sonuç: Evre IA, grade 1-2 ve LVSI
pozitif endometrial kanserli olgular ve Evre IB, grade 1-2 ve LVSI pozitif
endometrial kanserli olguların DFS ve OS oranlarının benzer olduğu görülmüştür.

References

  • [1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7–30.
  • [2] Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet 2005; 366:491–505.
  • [3] Sorosky JI. Endometrial Cancer. Obstet Gynecol 2012; 120:383–397.
  • [4] Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009; 105:103–4.
  • [5] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004; 92:744–751.
  • [6] Nout RA, van de Poll-Franse L V, Lybeert MLM, Wárlám-Rodenhuis CC, Jobsen JJ, Mens JWM, et al. Long-Term Outcome and Quality of Life of Patients With Endometrial Carcinoma Treated With or Without Pelvic Radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) Trial. J Clin Oncol 2011; 29:1692–1700.
  • [7] Sadozye AH, Harrand RL, Reed NS. Lymphovascular Space Invasion as a Risk Factor in Early Endometrial Cancer. Curr Oncol Rep 2016; 18:24.
  • [8] Guntupalli SR, Zighelboim I, Kizer NT, Zhang Q, Powell MA, Thaker PH, et al. Lymphovascular space invasion is an independent risk factor for nodal disease and poor outcomes in endometrioid endometrial cancer. Gynecol Oncol 2012; 124:31–35.
  • [9] Weinberg LE, Kunos CA, Zanotti KM. Lymphovascular Space Invasion (LVSI) Is an Isolated Poor Prognostic Factor for Recurrence and Survival Among Women With Intermediate- to High-Risk Early-Stage Endometrioid Endometrial Cancer. Int J Gynecol Cancer 2013; 23:1438–1445.
  • [10] Zhang C, Wang C, Feng W. Clinicopathological risk factors for pelvic lymph node metastasis in clinical early-stage endometrioid endometrial adenocarcinoma. Int J Gynecol Cancer 2012; 22:1373–7.
  • [11] Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J,et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2016; 27:16–41.
  • [12] Shepherd JH. Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 1989; 96:889–92.
  • [13] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial ofsurgery with or without adjunctive external pelvic radiationtherapy in intermediate risk endometrial adenocarcinoma: Agynecologic oncology group study. Gynecol Oncol 2004; 92:744–751.
  • [14] Cohn DE, Horowitz NS, Mutch DG, Kim SM, Manolitsas T, Fowler JM. Should the presence of lymphvascular space involvement be used to assign patients to adjuvant therapy following hysterectomy for unstaged endometrial cancer? Gynecol Oncol 2002; 87:243–6.
  • [15] Loizzi V, Cormio G, Lorusso M, Latorre D, Falagario M, Demitri P, et al.The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer. Eur J Cancer Care (Engl) 2014; 23:380–384.
  • [16] Creutzberg CL, Nout RA, Lybeert MLM, Wárlám-Rodenhuis CC, Jobsen JJ, Mens J-WM, et al. PORTEC Study Group. Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma. Int J Radiat Oncol 2011; 81:e631–e638.
  • [17] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. Gynecologic Oncology Group. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004; 92:744–751.
  • [18] Han KH, Kim HS, Lee M, Chung HH, Song YS. Prognostic factors for tumor recurrence in endometrioid endometrial cancer stages IA and IB. Medicine (Baltimore) 2017; 96:e6976.
  • [19] Mariani A, Webb MJ, Keeney GL, Lesnick TG, Podratz KC. Surgical Stage I Endometrial Cancer: Predictors of Distant Failure and Death. Gynecol Oncol 2002; 87:274–280.
  • [20] dos Reis R, Burzawa JK, Tsunoda AT, Hosaka M, Frumovitz M, Westin SN, et al. Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer. Int J Gynecol Cancer 2015; 25:1292–9.
  • [21] Aristizabal P, Graesslin O, Barranger E, Clavel-Chapelon F, Haddad B, Luton D, et al. A suggested modification to FIGO stage I endometrial cancer. Gynecol Oncol 2014; 133:192–196.

Comparison of stage IA and stage IB endometrial cancerpatients who were unequivocally LVSI positive and grade 1-2: Analysis of High Intermediate risk group which was currently defined by ESMO-ESGO-ESTRO Consensus in 2016

Year 2019, Volume: 50 Issue: 3, 112 - 116, 15.09.2019
https://doi.org/10.16948/zktipb.585846

Abstract

Objective: The patients with endometrial cancer have been devised
based on clinic-pathological prognostic factors to identify patients at the
risk of recurrence and to guide adjuvant therapy use. According to contemporary
guidelines, a new risk subgroup has been declared. Regardless of depth of
invasion, all patients who were unequivocally LVSI positive and grade 1-2
defined as High-intermediate risk group.
The purpose of this retrospective study was to compare
the prognoses of women with stage IA
high-intermediate endometrial
cancer to those women of stage IB
High-intermediate endometrial
cancer.

Methods: A
single center, retrospective department database review was performed to
identify patients with endometrial Cancer.
A total of 46 women with Stage
I endometrial cancer
who were unequivocally LVSI positive and grade 1-2 between 2008 and 2018 were
included in this retrospective study.
Seventeen (37%) were classified as Stage IA and 29 (63%)
as Stage IB.
Kaplan-Meier method was used to generate survival data.

Results:
The
5-year
disease-free survival (DFS) rate was 94.1% versus 82.3%(p=0.95) and 5-year overall survival (OS)
was94.1% versus 89%  (p=0.81) for stage
IA and stage IB, respectively.







Conclusion: DFS and OS rates of patients with Stage IA, grade 1-2
and LVSI positive endometrial cancer and Stage IB, grade 1-2 and LVSI positive
endometrial cancer seem to be similar. 

References

  • [1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68:7–30.
  • [2] Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet 2005; 366:491–505.
  • [3] Sorosky JI. Endometrial Cancer. Obstet Gynecol 2012; 120:383–397.
  • [4] Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009; 105:103–4.
  • [5] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004; 92:744–751.
  • [6] Nout RA, van de Poll-Franse L V, Lybeert MLM, Wárlám-Rodenhuis CC, Jobsen JJ, Mens JWM, et al. Long-Term Outcome and Quality of Life of Patients With Endometrial Carcinoma Treated With or Without Pelvic Radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) Trial. J Clin Oncol 2011; 29:1692–1700.
  • [7] Sadozye AH, Harrand RL, Reed NS. Lymphovascular Space Invasion as a Risk Factor in Early Endometrial Cancer. Curr Oncol Rep 2016; 18:24.
  • [8] Guntupalli SR, Zighelboim I, Kizer NT, Zhang Q, Powell MA, Thaker PH, et al. Lymphovascular space invasion is an independent risk factor for nodal disease and poor outcomes in endometrioid endometrial cancer. Gynecol Oncol 2012; 124:31–35.
  • [9] Weinberg LE, Kunos CA, Zanotti KM. Lymphovascular Space Invasion (LVSI) Is an Isolated Poor Prognostic Factor for Recurrence and Survival Among Women With Intermediate- to High-Risk Early-Stage Endometrioid Endometrial Cancer. Int J Gynecol Cancer 2013; 23:1438–1445.
  • [10] Zhang C, Wang C, Feng W. Clinicopathological risk factors for pelvic lymph node metastasis in clinical early-stage endometrioid endometrial adenocarcinoma. Int J Gynecol Cancer 2012; 22:1373–7.
  • [11] Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J,et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2016; 27:16–41.
  • [12] Shepherd JH. Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 1989; 96:889–92.
  • [13] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial ofsurgery with or without adjunctive external pelvic radiationtherapy in intermediate risk endometrial adenocarcinoma: Agynecologic oncology group study. Gynecol Oncol 2004; 92:744–751.
  • [14] Cohn DE, Horowitz NS, Mutch DG, Kim SM, Manolitsas T, Fowler JM. Should the presence of lymphvascular space involvement be used to assign patients to adjuvant therapy following hysterectomy for unstaged endometrial cancer? Gynecol Oncol 2002; 87:243–6.
  • [15] Loizzi V, Cormio G, Lorusso M, Latorre D, Falagario M, Demitri P, et al.The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer. Eur J Cancer Care (Engl) 2014; 23:380–384.
  • [16] Creutzberg CL, Nout RA, Lybeert MLM, Wárlám-Rodenhuis CC, Jobsen JJ, Mens J-WM, et al. PORTEC Study Group. Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma. Int J Radiat Oncol 2011; 81:e631–e638.
  • [17] Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. Gynecologic Oncology Group. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004; 92:744–751.
  • [18] Han KH, Kim HS, Lee M, Chung HH, Song YS. Prognostic factors for tumor recurrence in endometrioid endometrial cancer stages IA and IB. Medicine (Baltimore) 2017; 96:e6976.
  • [19] Mariani A, Webb MJ, Keeney GL, Lesnick TG, Podratz KC. Surgical Stage I Endometrial Cancer: Predictors of Distant Failure and Death. Gynecol Oncol 2002; 87:274–280.
  • [20] dos Reis R, Burzawa JK, Tsunoda AT, Hosaka M, Frumovitz M, Westin SN, et al. Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer. Int J Gynecol Cancer 2015; 25:1292–9.
  • [21] Aristizabal P, Graesslin O, Barranger E, Clavel-Chapelon F, Haddad B, Luton D, et al. A suggested modification to FIGO stage I endometrial cancer. Gynecol Oncol 2014; 133:192–196.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Koray Aslan 0000-0002-3432-7381

İbrahim Yalçın This is me 0000-0003-3469-1084

Hanifi Şahin 0000-0001-8522-9119

Mehmet Mutlu Meydanlı This is me 0000-0001-6763-9720

Publication Date September 15, 2019
Published in Issue Year 2019 Volume: 50 Issue: 3

Cite

APA Aslan, K., Yalçın, İ., Şahin, H., Meydanlı, M. M. (2019). LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi. Zeynep Kamil Tıp Bülteni, 50(3), 112-116. https://doi.org/10.16948/zktipb.585846
AMA Aslan K, Yalçın İ, Şahin H, Meydanlı MM. LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi. Zeynep Kamil Tıp Bülteni. September 2019;50(3):112-116. doi:10.16948/zktipb.585846
Chicago Aslan, Koray, İbrahim Yalçın, Hanifi Şahin, and Mehmet Mutlu Meydanlı. “LVSI Pozitif Ve Grade 1-2 tümörü Olan Evre IA Ve Evre IB Endometrial Kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış Olan yüksek-Orta Risk Grubunun Analizi”. Zeynep Kamil Tıp Bülteni 50, no. 3 (September 2019): 112-16. https://doi.org/10.16948/zktipb.585846.
EndNote Aslan K, Yalçın İ, Şahin H, Meydanlı MM (September 1, 2019) LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi. Zeynep Kamil Tıp Bülteni 50 3 112–116.
IEEE K. Aslan, İ. Yalçın, H. Şahin, and M. M. Meydanlı, “LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi”, Zeynep Kamil Tıp Bülteni, vol. 50, no. 3, pp. 112–116, 2019, doi: 10.16948/zktipb.585846.
ISNAD Aslan, Koray et al. “LVSI Pozitif Ve Grade 1-2 tümörü Olan Evre IA Ve Evre IB Endometrial Kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış Olan yüksek-Orta Risk Grubunun Analizi”. Zeynep Kamil Tıp Bülteni 50/3 (September 2019), 112-116. https://doi.org/10.16948/zktipb.585846.
JAMA Aslan K, Yalçın İ, Şahin H, Meydanlı MM. LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi. Zeynep Kamil Tıp Bülteni. 2019;50:112–116.
MLA Aslan, Koray et al. “LVSI Pozitif Ve Grade 1-2 tümörü Olan Evre IA Ve Evre IB Endometrial Kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış Olan yüksek-Orta Risk Grubunun Analizi”. Zeynep Kamil Tıp Bülteni, vol. 50, no. 3, 2019, pp. 112-6, doi:10.16948/zktipb.585846.
Vancouver Aslan K, Yalçın İ, Şahin H, Meydanlı MM. LVSI pozitif ve grade 1-2 tümörü olan evre IA ve evre IB endometrial kanser hastalarının karşılaştırılması: 2016 yılında ESMO-ESGO-ESTRO tarafından tanımlanmış olan yüksek-orta risk grubunun analizi. Zeynep Kamil Tıp Bülteni. 2019;50(3):112-6.