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Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)

In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). T...

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Autores principales: Chen, Jen-Ruei, Chang, Ting-Chang, Fu, Hung-Chun, Lau, Hei-Yu, Chen, I.-Hui, Ke, Yu-Min, Liang, Yu-Ling, Chiang, An-Jen, Huang, Chia-Yen, Chen, Yu-Chieh, Hong, Mun-Kun, Wang, Yu-Chi, Huang, Kuo-Feng, Hsiao, Sheng-Mou, Wang, Peng-Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839827/
https://www.ncbi.nlm.nih.gov/pubmed/27082583
http://dx.doi.org/10.1097/MD.0000000000003330
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author Chen, Jen-Ruei
Chang, Ting-Chang
Fu, Hung-Chun
Lau, Hei-Yu
Chen, I.-Hui
Ke, Yu-Min
Liang, Yu-Ling
Chiang, An-Jen
Huang, Chia-Yen
Chen, Yu-Chieh
Hong, Mun-Kun
Wang, Yu-Chi
Huang, Kuo-Feng
Hsiao, Sheng-Mou
Wang, Peng-Hui
author_facet Chen, Jen-Ruei
Chang, Ting-Chang
Fu, Hung-Chun
Lau, Hei-Yu
Chen, I.-Hui
Ke, Yu-Min
Liang, Yu-Ling
Chiang, An-Jen
Huang, Chia-Yen
Chen, Yu-Chieh
Hong, Mun-Kun
Wang, Yu-Chi
Huang, Kuo-Feng
Hsiao, Sheng-Mou
Wang, Peng-Hui
author_sort Chen, Jen-Ruei
collection PubMed
description In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n = 464; stage IV, n = 77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0–258 months) and median OS was 52 months (range 1–258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12–2.09; P = 0.007), histological grade 3 (HR 2.0, 95% CI 1.47–2.75; P < 0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13–6.72; P < 0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34–2.64; P < 0.001), and histological grade 3 (HR 2.42, 95% CI 1.75–3.35; P < 0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16–0.45; P < 0.001, and HR 0.14, 95% CI 0.08–0.26; P < 0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79–0.92; P = 0.017, and HR 0.48; 95% CI 0.31–0.75; P = 0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.
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spelling pubmed-48398272016-06-02 Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article) Chen, Jen-Ruei Chang, Ting-Chang Fu, Hung-Chun Lau, Hei-Yu Chen, I.-Hui Ke, Yu-Min Liang, Yu-Ling Chiang, An-Jen Huang, Chia-Yen Chen, Yu-Chieh Hong, Mun-Kun Wang, Yu-Chi Huang, Kuo-Feng Hsiao, Sheng-Mou Wang, Peng-Hui Medicine (Baltimore) 5600 In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n = 464; stage IV, n = 77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0–258 months) and median OS was 52 months (range 1–258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12–2.09; P = 0.007), histological grade 3 (HR 2.0, 95% CI 1.47–2.75; P < 0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13–6.72; P < 0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34–2.64; P < 0.001), and histological grade 3 (HR 2.42, 95% CI 1.75–3.35; P < 0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16–0.45; P < 0.001, and HR 0.14, 95% CI 0.08–0.26; P < 0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79–0.92; P = 0.017, and HR 0.48; 95% CI 0.31–0.75; P = 0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality. Wolters Kluwer Health 2016-04-18 /pmc/articles/PMC4839827/ /pubmed/27082583 http://dx.doi.org/10.1097/MD.0000000000003330 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5600
Chen, Jen-Ruei
Chang, Ting-Chang
Fu, Hung-Chun
Lau, Hei-Yu
Chen, I.-Hui
Ke, Yu-Min
Liang, Yu-Ling
Chiang, An-Jen
Huang, Chia-Yen
Chen, Yu-Chieh
Hong, Mun-Kun
Wang, Yu-Chi
Huang, Kuo-Feng
Hsiao, Sheng-Mou
Wang, Peng-Hui
Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title_full Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title_fullStr Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title_full_unstemmed Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title_short Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG–2005) Retrospective Cohort Study (A STROBE-Compliant Article)
title_sort outcomes of patients with surgically and pathologically staged iiia-ivb pure endometrioid-type endometrial cancer: a taiwanese gynecology oncology group (tgog–2005) retrospective cohort study (a strobe-compliant article)
topic 5600
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839827/
https://www.ncbi.nlm.nih.gov/pubmed/27082583
http://dx.doi.org/10.1097/MD.0000000000003330
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