Uterine serous and Grade 3 endometrioid carcinomas - Is there a survival difference?
Uterine serous and Grade 3 endometrioid carcinomas - Is there a survival difference?
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DOI：
10.1002/cncr.20645
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发表时间：
2004-11-15
期刊：
影响因子：
6.2
通讯作者：
Van Le, L
中科院分区：
文献类型：
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作者：
Boruta, DM;Gehrig, PA;Van Le, L
背景据报道，子宫内膜癌中的浆液成分是不良的指示剂。然而，据作者所知，为了影响结果，必须由浆液成分组成的肿瘤的百分比是未知的。作者比较了子宫内膜癌（包括不同比例的子宫浆液性癌（USC））和国际妇产科联合会（FIGO）3级子宫内膜样癌（G3 EC）患者的总生存期（OS），以确定这两种低分化组织学之间的结局是否存在差异。回顾性收集了1990年1月至2000年11月期间诊断为G3 EC或USC的妇女的数据。对病例进行回顾性分析，以确定诊断并估计肿瘤组成USC的比例。评估的变量包括患者的年龄和种族、肿瘤分期和淋巴血管浸润。使用Fisher精确检验检验变量之间的关联。使用Kaplan-Meier方法评价OS，并使用对数秩检验进行比较。确定了52名G3 EC女性和87名USC女性。发现肿瘤中USC> 50%的女性患者的OS显著低于G3 EC女性患者（风险比[HR]为2.4; 95%置信区间[95% CI]，1.2-5.2）。患有USC的女性更可能出现宫外疾病（比值比为2.2; 95%CI，1.1-4.5）。G3 EC女性的5年生存率为75%，而肿瘤> 50% USC的女性为41%（P = 0.01）。与G3 EC患者相比，即使10%的USC患者的OS也有明显恶化的趋势。与G3 EC女性的OS相比，发现USC涉及> 50%的子宫内膜癌预测OS更差。在患有早期疾病的患者中，发现当USC甚至占肿瘤的10%时，存在预后更差的趋势。对子宫内膜癌治疗的研究应包括并记录任何百分比的USC肿瘤。癌症2004;101：2214-21. (C)2004年美国癌症协会。
BACKGROUND. Serous components within endometrial carcinoma are reportedly poor prognosticators. However, to the authors' knowledge the percentage of tumors which must be comprised of a serous component in order to affect outcome is unknown. The authors compared overall survival (OS) in women with endometrial carcinomas comprised of various percentages of uterine serous carcinoma (USC) with that of women with International Federation of Gynecology and Obstetrics (FIGO) Grade 3 endometrioid carcinoma (G3EC) to determine whether outcomes varied between these two poorly differentiated histologies.METHODS. Data concerning women with either G3EC or USC who were diagnosed between January 1990 and November 2000 were collected retrospectively. Cases were reviewed to confirm diagnosis and estimate the fraction of tumor comprised of USC. Variables assessed included patient age and race, tumor stage, and lymphovascular space invasion. Associations between variables were tested using the Fisher exact test. The Kaplan-Meier method was used to evaluate OS with comparisons performed using the log-rank test.RESULTS. Fifty-two women with G3EC and 87 women with USC were identified. The OS of women with tumors comprised of > 50% USC was found to be significantly worse compared with women with G3EC (hazard ratio [HR] of 2.4; 95% confidence interval [95% CI], 1.2-5.2). Women with USC were more likely to present with extrauterine disease (odds ratio of 2.2; 95% CI, 1.1-4.5). The 5-year survival rate for women with G3EC was 75% compared with 41% for women with tumors that were > 50% USC (P = 0.01). There was a significant trend toward a worse OS in women with even 10% USC compared with women with G3EC.CONCLUSIONS. USC involving > 50% of an endometrial carcinoma was found to be predictive of worse OS compared with the OS of women with G3EC. In patients with early-stage disease, a trend toward a worse prognosis was found to exist when USC comprised even 10% of a tumor. Investigation into the treatment of endometrial carcinoma should include and document tumors with any percentage comprised of USC. Cancer 2004;101:2214-21. (C) 2004 American Cancer Society.