The nature of early-stage endometrial cancer recurrence-A national cohort study
The nature of early-stage endometrial cancer recurrence-A national cohort study
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DOI：
10.1016/j.ejca.2016.09.033
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发表时间：
2016-12-01
影响因子：
8.4
通讯作者：
Mogensen, Ole
中科院分区：
文献类型：
--
作者：
Jeppesen, Mette Moustgaard;Jensen, Pernille Tine;Mogensen, Ole
背景和目的：本研究的目的是对丹麦早期子宫内膜癌患者的大规模队列进行疾病复发的综合分析，这些患者均按照国家指南进行治疗。方法：所有2005-2009年诊断为I期或II期子宫内膜癌的妇女纳入基于人群的历史队列，该队列来自丹麦妇科癌症数据库。通过国家登记和医院图表确定原发性诊断后疾病复发达3年。生存随访于2014年12月31日结束。我们使用多变量逻辑回归评估临床病理和社会人口学变量的预测价值。结果：在纳入的2612名妇女中，有183人（7%）在初次治疗后3年内诊断出复发。复发部位对总生存率有显著影响，阴道复发妇女的5年生存率为64.8%，远处复发妇女的5年生存率为17.5%。预测复发的因素包括国际妇产联合会（FIGO）分期（OR: IB = 1.91， II期= 3.91），Charlson合并症指数为3 (OR 1.86)，非子宫内膜样组织学（OR 1.81）和不在工作场所（OR 1.81）。FIGO分期预测阴道复发（OR: IB= 1.88, II = 2.79），而FIGO分期预测阴道外复发（OR: IB=2.12, II = 3.31）、Charlson合病指数3 （OR 1.88）和非子宫内膜样组织学（OR 2.51）。结论：未来的研究应寻求了解已确定的预测因素的潜在机制，以提高复发预测并降低发病率和死亡率。(C) 2016 Elsevier Ltd.版权所有。
Background and aims: The aim of the study was to present a comprehensive analysis of disease recurrence in a large Danish cohort of women with early-stage endometrial cancer treated according to national guidelines.Methods: All women diagnosed with stage I or II endometrial cancer in 2005-2009 were included in a population-based historical cohort derived from the Danish Gynaecological Cancer Database. Disease recurrence up to 3 years after the primary diagnosis was identified using national registers and hospital charts. Follow-up on survival ended on 31st December 2014. We evaluated the predictive value of clinico-pathological and sociodemographic variables using multivariate logistic regression.Results: Recurrence within 3 years of the primary treatment was diagnosed in 183 (7%) of the included 2612 women. Site of recurrence significantly impacted on overall survival as the 5-year survival rate was 64.8% for women with vaginal recurrence and 17.5% in women with distant recurrence. Factors predictive of recurrence included the International Federation of Gynaecology and Obstetrics (FIGO) stage (OR: IB = 1.91, stage II = 3.91), Charlson comorbidity index of 3 (OR 1.86), non-endometrioid histology (OR 1.81) and being outside of the workforce (OR 1.81). Vaginal recurrence was predicted by FIGO stage only (OR: IB = 1.88, II = 2.79), while extra-vaginal recurrence was predicted by FIGO stage (OR: IB=2.12, II = 3.31), Charlson comorbidity index of 3 (OR 1.88) and non-endometrioid histology (OR 2.51).Conclusions: Future research should seek to understand the underlying mechanisms of the identified predictive factors to improve recurrence prediction and to reduce morbidity and mortality. (C) 2016 Elsevier Ltd. All rights reserved.