TY - JOUR
T1 - Temporal pattern of recurrence of stage i endometrial cancer in relation to histological risk factors
AU - Ben Arie, A.
AU - Lavie, O.
AU - Gdalevich, M.
AU - Voldarsky, M.
AU - Barak, F.
AU - Schneider, D.
AU - Levy, T.
AU - Anteby, E.
AU - Gemer, O.
PY - 2012/2
Y1 - 2012/2
N2 - Objective: To study the temporal pattern of endometrial cancer recurrence in relation to histological risk factors in a large multicenter setting. Methods: 843 patients with apparent stage I endometrial cancer were followed for a median time of 38 months, documenting all recurrences. Patients were stratified as high risk based on the presence of at least one of the established histological risk factors: high tumor grade, penetration to the outer half of the myometrium, lymphvascular space involvement, lower uterine segment involvement and non endometroid histology. Survival analysis, including Kaplan-Meier curves, log-rank tests and multi-variate Cox proportional hazard regression were used to evaluate the equality of recurrence-free distributions for different levels of risk. Results: Recurrence was documented in 66 cases. The presence of one or more of the histological risk factors was associated with significantly shorter recurrence free survival, not attenuating over time (p < 0.001). Age-adjusted Cox regression model demonstrated a significantly decreased recurrence-free survival (HR = 2.8 95% CI 1.5, 5.1) in the presence of risk factors. Conclusions: In patients with stage I endometrial cancer, the presence of histological risk factors is associated with a significantly higher recurrence rate, which does not attenuate over follow up time. This may allow for a selective approach in the follow- up of endometrial cancer patients.
AB - Objective: To study the temporal pattern of endometrial cancer recurrence in relation to histological risk factors in a large multicenter setting. Methods: 843 patients with apparent stage I endometrial cancer were followed for a median time of 38 months, documenting all recurrences. Patients were stratified as high risk based on the presence of at least one of the established histological risk factors: high tumor grade, penetration to the outer half of the myometrium, lymphvascular space involvement, lower uterine segment involvement and non endometroid histology. Survival analysis, including Kaplan-Meier curves, log-rank tests and multi-variate Cox proportional hazard regression were used to evaluate the equality of recurrence-free distributions for different levels of risk. Results: Recurrence was documented in 66 cases. The presence of one or more of the histological risk factors was associated with significantly shorter recurrence free survival, not attenuating over time (p < 0.001). Age-adjusted Cox regression model demonstrated a significantly decreased recurrence-free survival (HR = 2.8 95% CI 1.5, 5.1) in the presence of risk factors. Conclusions: In patients with stage I endometrial cancer, the presence of histological risk factors is associated with a significantly higher recurrence rate, which does not attenuate over follow up time. This may allow for a selective approach in the follow- up of endometrial cancer patients.
KW - Endometrial cancer
KW - Prognostic factors
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=84855838554&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2011.10.011
DO - 10.1016/j.ejso.2011.10.011
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AN - SCOPUS:84855838554
SN - 0748-7983
VL - 38
SP - 166
EP - 169
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 2
ER -
