Significance of abnormal peritoneal cytology on survival of women with stage I-II endometrioid endometrial cancer.
Significance of abnormal peritoneal cytology on survival of women with stage I-II endometrioid endometrial cancer.
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DOI：
10.1016/j.ygyno.2018.02.012
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发表时间：
2018-05
影响因子：
4.7
通讯作者：
Roman LD
中科院分区：
文献类型：
--
作者：
Matsuo K;Yabuno A;Hom MS;Shida M;Kakuda M;Adachi S;Mandelbaum RS;Ueda Y;Hasegawa K;Enomoto T;Mikami M;Roman LD
研究腹膜细胞学检查显示恶性或非典型细胞（腹膜细胞学检查异常）的I-II期子宫内膜样癌患者的生存率。这是一项多中心回顾性研究，检查了1668名在2000年至2015年期间接受初次子宫切除术并获得腹膜细胞学结果的I-II期子宫内膜样癌女性。腹腔细胞学异常与临床病理特征和肿瘤学结局相关。恶性细胞125例（7.5%），非典型细胞58例（3.5%）。在多因素分析中，非肥胖、非糖尿病、吸烟和淋巴血管间隙侵犯与腹膜细胞学异常独立相关（所有，P < 0.05）。多变量分析显示，异常腹膜细胞学与无病生存率（风险比3.07，P < 0.001）和病因特异性生存率（风险比3.42，P = 0.008）降低独立相关。与阴性细胞学检查相比，异常腹膜细胞学检查与远处复发风险增加显著相关（5年率：8.8% vs 3.6%，P = 0.001），但与局部复发风险无关（5.2% vs 3.0%，P = 0.32）。在I期疾病的女性中，腹膜细胞学异常与低风险组的远处复发风险增加显著相关（5年率：5.5%对1.0%，P < 0.001），但在高-中风险组中则无关（13.3%对10.8%，P = 0.60）。在183例腹膜细胞学检查异常的妇女中，术后化疗显著降低了腹膜复发率（5年率：1.3% vs 9.2%，P = 0.039），而术后放疗没有降低腹膜复发率（7.1% vs 5.5%，P = 0.63）。我们的研究表明，异常的腹腔细胞学检查可能是一个预后因素，降低生存期的I-II期子宫内膜样癌的妇女，特别是对低风险组。
To examine survival of women with stage I–II endometrioid endometrial cancer whose peritoneal cytology showed malignant or atypical cells (abnormal peritoneal cytology). This is a multi-center retrospective study examining 1668 women with stage I–II endometrioid endometrial cancer who underwent primary hysterectomy with available peritoneal cytology results between 2000 and 2015. Abnormal peritoneal cytology was correlated to clinico-pathological characteristics and oncological outcome. Malignant and atypical cells were seen in 125 (7.5%) and 58 (3.5%) cases, respectively. On multivariate analysis, non-obesity, non-diabetes mellitus, cigarette use, and lympho-vascular space invasion were independently associated with abnormal peritoneal cytology (all, P < 0.05). Abnormal peritoneal cytology was independently associated with decreased disease-free survival (hazard ratio 3.07, P < 0.001) and cause-specific survival (hazard ratio 3.42, P = 0.008) on multivariate analysis. Abnormal peritoneal cytology was significantly associated with increased risks of distant-recurrence (5-year rates: 8.8% versus 3.6%, P = 0.001) but not local-recurrence (5.2% versus 3.0%, P = 0.32) compared to negative cytology. Among women with stage I disease, abnormal peritoneal cytology was significantly associated with an increased risk of distant-recurrence in the low risk group (5-year rates: 5.5% versus 1.0%, P < 0.001) but not in the high-intermediate risk group (13.3% versus 10.8% P = 0.60). Among 183 women who had abnormal peritoneal cytology, postoperative chemotherapy significantly reduced the rate of peritoneal recurrence (5-year rates: 1.3% versus 9.2%, P = 0.039) whereas postoperative radiotherapy did not (7.1% versus 5.5%, P = 0.63). Our study suggests that abnormal peritoneal cytology may be a prognostic factor for decreased survival in women with stage I–II endometrioid endometrial cancer, particularly for low-risk group.
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DOI：
10.1097/igc.0000000000001181
发表时间：
2018-03
期刊：
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
影响因子：
--
作者：
Machida H;Hom MS;Adams CL;Eckhardt SE;Garcia-Sayre J;Mikami M;Matsuo K
通讯作者：
Matsuo K
影响因子：
64.8
作者：
通讯作者：
--
影响因子：
8.8
作者：
Kasamatsu, T;Onda, T;Matsuno, Y
通讯作者：
Matsuno, Y
影响因子：
7.5
作者：
Fadare, O;Mariappan, MR;Rimm, DL
通讯作者：
Rimm, DL
DOI：
10.1016/s0360-3016(96)00619-0
发表时间：
1997-03-01
影响因子：
7
作者：
Gaspar, L;Scott, C;Byhardt, R
通讯作者：
Byhardt, R