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European Journal of Gynaecological Oncology  2019, Vol. 40 Issue (2): 254-261    DOI: 10.12892/ejgo4572.2019
Original Research Previous articles | Next articles
Prognostic factors in high-grade endometrial cancer: does subtype matter?
L. Baquedano1, *(), S. Castan1, M. A. Ruiz-Conde1, M. A. Martinez-Maestre2, D. Judez3, P. J. Coronado4
1Department of Obstetrics and Gynecology, Hospital Miguel Servet, Zaragoza, Spain
2Department of Obstetrics and Gynecology., Hospital Virgen del Rocio, Sevilla, Spain
3Department of Anesthesiology. Hospital Alcañiz, Teruel, Spain
4Department of Obstetrics and Gynecology. Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
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Abstract  

Objective: To assess the clinicopathologic features, prognostic factors, and survival of all histotypes of high-grade endometrial cancer. Materials and Methods: The authors performed a multicenter retrospective cohort study in 378 women with high-grade histotypes of endometrial cancer: 141 grade 3 endometrioid carcinomas (G3E), 65 clear-cell carcinomas (CCC), 95 uterine serous cancer (USC), and 77 carcinosarcomas (CS) diagnosed between 2001 and 2014. All patients underwent a hysterectomy and bilateral salpingo-oophorectomy as first-line treatment, and 254 subsequently had a lymphadenectomy. Demographic, histological, and survival data were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier curves and Cox multivariate regression analysis. Results: The mean age was 68.7 ± 10.5 years and was similar in the four histotypes. USC and CS were diagnosed in an advanced stage more frequently than G3E and CCC (p < 0.01). After a median follow-up of 34.6 (interquartile range 16.6-73.6) months, DFS was lower in USC [adjusted hazard ratio (HR): USC 2.20, 95% confidence interval (CI) 1.38-3.52] and CS (2.6, 1.63-4.30) compared with G3E and CCC (1.35, 0.78-2.32). Similar results were observed in terms of OS. Independent predictor factors of DFS and OS were: age, USC, and CS histotypes, deep myometrial invasion (MI), advanced FIGO Stage, and p53 overexpression. Adjuvant chemo-radiation was an independent factor of good prognosis. Conclusions: High-grade EC histotypes have high rates of recurrence and mortality. There are differences among histotypes, as USC and CS are more aggressive than G3E and CCC.

Key words:  Endometrial carcinoma      Survival      High-grade      Clinicopathologic prognostic factors      Outcomes     
Published:  10 April 2019     
*Corresponding Author(s):  L. BAQUEDANO     E-mail:  lbaquedanome@hotmail.com

Cite this article: 

L. Baquedano, S. Castan, M. A. Ruiz-Conde, M. A. Martinez-Maestre, D. Judez, P. J. Coronado. Prognostic factors in high-grade endometrial cancer: does subtype matter?. European Journal of Gynaecological Oncology, 2019, 40(2): 254-261.

URL: 

https://ejgo.imrpress.com/EN/10.12892/ejgo4572.2019     OR     https://ejgo.imrpress.com/EN/Y2019/V40/I2/254

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