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Impact of Lymph Node Ratio and Adjuvant Therapy in Node-Positive Endometrioid Endometrial Cancer
| Content Provider | Scilit |
|---|---|
| Author | Fleming, Nicole D. Soliman, Pamela T. Westin, Shannon N. Reis, Ricardo Dos Munsell, Mark Klopp, Ann H. Frumovitz, Michael Nick, Alpa M. Schmeler, Kathleen Ramirez, Pedro T. |
| Copyright Year | 2015 |
| Description | Journal: International Journal of Gynecologic Cancer 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 institutional review board approval, a retrospective review of patients diagnosed as having 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 were collected. Univariate and multivariate analysis were used to identify prognostic factors for progression-free (PFS) and overall survival. 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 years), and median follow-up was 49.4 months (range, 0.1–301.6 months). Age >70 years was identified as a prognostic factor for worse PFS (P = 0.0002) and overall survival (P = 0.0002) on multivariate analysis. Patients in this cohort receiving any adjuvant radiotherapy showed improved PFS (hazard ratio [HR], 0.34; 95% CI, 0.13–0.90; P = 0.03) compared with those receiving any adjuvant chemotherapy (HR, 2.33; 95% CI, 1.16–4.65; P = 0.02). In a subgroup analysis, patients with at least 10 nodes removed (n = 81) with an LNR greater than 50% had a PFS of 25.2 months compared with 135.6 months with an LNR of 50% or less (HR, 3.87; 95% CI, 1.15–13.04; P = 0.03). Conclusions Lymph node ratio may define a subgroup of stage IIIC endometrial cancers at increased risk for recurrence. Adjuvant radiotherapy was associated with decreased recurrence risk. |
| Related Links | http://europepmc.org/articles/pmc4581897?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581897/pdf |
| Ending Page | 1444 |
| Page Count | 8 |
| Starting Page | 1437 |
| ISSN | 1048891X |
| e-ISSN | 15251438 |
| DOI | 10.1097/igc.0000000000000510 |
| Journal | International Journal of Gynecologic Cancer |
| Issue Number | 8 |
| Volume Number | 25 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2015-10-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: International Journal of Gynecologic Cancer Obstetrics and Gynecology Multivariate Analysis Endometrial Cancer Stage Iiic |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
