Impact of histology and surgical approach on survival among women with early-stage, high-grade uterine cancer: An NRG Oncology/Gynecologic Oncology Group ancillary analysis.
Impact of histology and surgical approach on survival among women with early-stage, high-grade uterine cancer: An NRG Oncology/Gynecologic Oncology Group ancillary analysis.
复制标题
DOI：
10.1016/j.ygyno.2016.10.016
复制
发表时间：
2016-12
影响因子：
4.7
通讯作者：
Walker JL
中科院分区：
文献类型：
--
作者：
Fader AN;Java J;Tenney M;Ricci S;Gunderson CC;Temkin SM;Spirtos N;Kushnir CL;Pearl ML;Zivanovic O;Tewari KS;O'Malley D;Hartenbach EM;Hamilton CA;Gould NS;Mannel RS;Rodgers W;Walker JL
我们试图分析参加妇科肿瘤组（GOG） LAP2试验的高级别子宫癌（UC）妇女的临床病理特征、复发模式和生存结果。这是一项针对3级子宫内膜样腺癌（ENDO）、子宫浆液性（USC）、透明细胞（CC）和癌肉瘤（CS）的LAP-2患者的事后分析。通过组织学和手术入路比较了人口统计学、临床病理特征和复发模式。使用Kaplan-Meier法估计无进展生存期（PFS）和总生存期（OS）。在LAP-2试验的2600例患者中，753例患者为高级别UC: 350例为ENDO， 289例为USC， 42例为CC， 72例为CS。与ENDO组相比，其他高级别亚型患者年龄较大（p < 0.001），腹膜细胞学阳性（p < 0.001）、淋巴结阳性（p = 0.05）和最终病理分期较高（p < 0.001）的可能性更大。中位随访时间为60个月，与ENDO患者相比，USC、CCC和CS亚型患者的复发率（p < 0.001）、盆腔外复发（p < 0.001）较高，PFS （p < 0.001）和OS （p < 0.001）较差。诊断为USC和CS的患者生存期最差（p = 0.003）。LSC和LAP分期的复发和生存模式没有差异。在多变量分析中，年龄、分期、盆腔清洗和II型组织学与生存率独立且负相关。具有明显早期、USC和CS组织学的女性预后比患有3级子宫内膜样腺癌的女性差。复发模式和生存不受手术方法的影响。
We sought to analyze the clinicopathologic features, recurrence patterns and survival outcomes of women with high-grade uterine cancer (UC) enrolled on The Gynecologic Oncology Group (GOG) LAP2 trial. This is a post-hoc analysis of LAP-2 patients with grade 3 endometrioid adenocarcinoma (ENDO), uterine serous (USC), clear cell (CC) and carcinosarcoma (CS). Demographics, clinicopathologic features, and recurrence patterns, were compared by histology and surgical approach. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Of the 2600 patients enrolled in LAP-2, 753 patients had high-grade UC: 350 had ENDO, 289 had USC, 42 had CC and 72 had CS. Compared with the ENDO cohort, those with other high-grade subtypes were older (p < 0.001) and were more likely to have positive peritoneal cytology (p < 0.001), positive lymph nodes (p = 0.05) and higher disease stage on final pathology (p < 0.001). With a median follow-up time of 60 months, compared to patients with ENDO, those with USC, CCC and CS subtypes had higher recurrence rates (p < 0.001), extra-pelvic recurrences (p < 0.001) and poorer PFS (p < 0.001) and OS (p < 0.001). Those diagnosed with USC and CS experienced the worst survival outcomes (p = 0.003). Patterns of recurrence and survival were not different in those staged with LSC vs LAP. On multivariable analysis, age, stage, pelvic washings and Type II histology were independently and adversely associated with survival. Women with apparent early-stage, USC and CS histologies have poorer outcomes than women with grade 3 endometrioid adenocarcinoma. Patterns of recurrence and survival were not impacted by surgical approach.
登录
查看更多内容
影响因子：
64.8
作者：
通讯作者：
--
影响因子：
1.6
作者：
Pearson, Karl
通讯作者：
Pearson, Karl
影响因子：
8.8
作者：
通讯作者：
--
影响因子：
4.7
作者：
Homesley, Howard D.;Filiaci, Virginia;Gibbons, Susan K.;Long, Harry J.;Cella, David;Spirtos, Nick M.;Morris, Robert T.;DeGeest, Koen;Lee, Roger;Montag, Anthony
通讯作者：
Montag, Anthony
影响因子：
4.7
作者：
McMeekin, D. Scott;Filiaci, Virginia L.;Rodgers, William H.
通讯作者：
Rodgers, William H.