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Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment
| Content Provider | Scilit |
|---|---|
| Author | Barlin, Joyce N. Soslow, Robert A. Lutz, Megan Zhou, Qin C. Clair, Caryn M. St. Leitao, Mario M. Iasonos, Alexia Hensley, Martee L. Barakat, Richard R. Matias-Guiu, Xavier Abu-Rustum, Nadeem R. |
| Copyright Year | 2013 |
| Description | Journal: International Journal of Gynecologic Cancer Objective: We propose a new staging system for stage I endometrial cancer and compare its performance to the 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) systems.Methods: We analyzed patients with 1988 FIGO stage I endometrial cancer from January 1993 to August 2011. Low-grade carcinoma consisted of endometrioid grade 1 to grade 2 lesions. High-grade carcinoma consisted of endometrioid grade 3 or nonendometrioid carcinomas (serous, clear cell, and carcinosarcoma). The proposed system is as follows:IA. Low-grade carcinoma with less than half myometrial invasion IA1: Negative nodes IA2: No nodes removed IB. High-grade carcinoma with no myometrial invasion IB1: Negative nodes IB2: No nodes removed IC. Low-grade carcinoma with half or greater myometrial invasion IC1: Negative nodes IC2: No nodes removed ID. High-grade carcinoma with any myometrial invasion ID1: Negative nodes ID2: No nodes removed Results: Data from 1843 patients were analyzed. When patients were restaged with our proposed system, the 5-year overall survival significantly differed (P < 0.001): IA1, 96.7%; IA2, 92.2%; IB1, 92.2%; IB2, 76.4%; IC1, 83.9%; IC2, 78.6%; ID1, 81.1%; and ID2, 68.8%. The bootstrap-corrected concordance probability estimate for the proposed system was 0.627 (95% confidence interval, 0.590–0.664) and was superior to the concordance probability estimate of 0.530 (95% confidence interval, 0.516–0.544) for the 2009 FIGO system.Conclusions: By incorporating histological subtype, grade, myometrial invasion, and whether lymph nodes were removed, our proposed system for stage I endometrial cancer has a superior predictive ability over the 2009 FIGO staging system and provides a novel binary grading system (low-grade including endometrioid grade 1–2 lesions; high-grade carcinoma consisting of endometrioid grade 3 carcinomas and nonendometrioid carcinomas). |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405774/pdf |
| Ending Page | 1628 |
| Page Count | 9 |
| Starting Page | 1620 |
| ISSN | 1048891X |
| e-ISSN | 15251438 |
| DOI | 10.1097/igc.0b013e3182a5055e |
| Journal | International Journal of Gynecologic Cancer |
| Issue Number | 9 |
| Volume Number | 23 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2013-11-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: International Journal of Gynecologic Cancer Endocrinology and Metabolism Endometrial Cancer Stage I |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
