Clinical features related to lymphatic metastasis in grade 3 endometroid endometrial cancer: a retrospective cross-sectional study.
Clinical features related to lymphatic metastasis in grade 3 endometroid endometrial cancer: a retrospective cross-sectional study.
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3级子宫内膜样子宫内膜癌淋巴转移相关的临床特征：一项回顾性横断面研究
DOI：
10.1097/cm9.0000000000001749
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发表时间：
2021-08-23
影响因子：
6.1
通讯作者：
Wang C
中科院分区：
文献类型：
--
作者：
Wang B;Wang Q;Shi Y;Shao WY;Liao JB;Luo XZ;Chen XJ;Wang C
子宫内膜癌（EC）是妇科恶性肿瘤中最常见的癌症之一;然而，对于3级（G3）子宫内膜样子宫内膜癌（EEC）患者的临床治疗策略存在争议。本研究旨在探讨G3期食管癌淋巴结转移的相关因素及淋巴结清扫的必要性。2009年1月至2019年4月，复旦大学附属妇产科医院共收治EC患者3751例。临床特征包括年龄、分级、分期和临床病理特征。共有1235例EEC患者参与多变量分析。381例患者参与了生存分析，数据归因于足够的随访信息。采用Kaplan-Meier曲线和log-rank检验分析生存率。在1235例EEC患者中，181例（14.7%）归类为G3，1054例（85.3%）归类为1级至2级（G1-2）。多变量分析表明，淋巴血管间隙侵犯、附件受累和宫颈间质受累是G3队列中LM的独立危险因素，比值比分别为3.4、5.8和8.9; 95%置信区间分别为1.1-10.6、1.5-22.4和2.8-28.0。随着相关因素数量从1增加到3，G3 EEC队列的LM发生率从3.3%（3/92）增加到75%（9/12）。G3和G1-2 EEC之间的总生存期和无进展生存期无差异。此外，G3 EEC患者在早期采用不同的辅助治疗方案时没有观察到生存优势。无其他病理阳性因素的G3期EEC患者，LM发生率低于有其他病理阳性因素者。生存分析显示G3队列和G1-2队列之间无差异。此外，不同的辅助治疗对G3 EEC患者的总生存率没有影响。
Endometrial cancer (EC) has been one of the most general cancers with respect to gynecological malignancies; however, there are debates on clinical strategies concerning treatments especially for patients with grade 3 (G3) endometroid endometrial cancer (EEC). Present study aimed to evaluate the lymphatic metastasis (LM) related factors and figure out the necessity of lymphadenectomy for G3 EEC patients. From January 2009 to April 2019, 3751 EC patients were admitted to Obstetrics and Gynecology Hospital of Fudan University. Clinical characteristics include age, grade, stage, and clinical pathological features. A total of 1235 EEC patients were involved in the multivariable analysis. Three hundred and eighty-one patients were involved in the survival analysis and the data attributed to sufficient follow-up information. Kaplan-Meier curve and log-rank test were utilized to analyze the survival rate. Among the 1235 EEC patients, 181 (14.7%) were categorized as G3 and 1054 (85.3%) were grade 1 to grade 2 (G1-2). Multivariate analysis demonstrated that lymphovascular space invasion, adnexal involvement, and cervical stroma involvement were independent risk factors of LM in G3 cohort with odds ratio 3.4, 5.8, and 8.9; 95% confidence interval 1.1–10.6, 1.5–22.4, and 2.8–28.0, respectively. LM rates increased from 3.3% (3/92) to 75% (9/12) for G3 EEC cohort as related factor numbers increased from one to three. There were no differences between G3 and G1-2 EEC in overall survival and progression free survival. Additionally, no survival advantage was observed for G3 EEC patients at early stage with different plans of adjuvant treatment. For G3 EEC patients without other pathological positive factor, the LM rate is lower than those with other pathological positive factor. Survival analysis showed no difference between G3 cohort and G1-2 cohort. Also, different adjuvant treatments had no impact on the overall survival for G3 EEC patients.
影响因子：
3.9
作者：
Kang S;Lee JM;Lee JK;Kim JW;Cho CH;Kim SM;Park SY;Park CY;Kim KT
通讯作者：
Kim KT