Cargando…
Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study
PURPOSE: To determine whether systemic lymphadenectomy exerts a similar effect on the survival of patients with either type I or type II endometrial cancer (EC). PATIENTS AND METHODS: In this retrospective study, 682 eligible patients diagnosed with EC were typed according to the pathological report...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721119/ https://www.ncbi.nlm.nih.gov/pubmed/33299347 http://dx.doi.org/10.2147/CMAR.S280780 |
_version_ | 1783619977814736896 |
---|---|
author | Xu, Jie Chen, Can Xiong, Jing Linghu, Hua |
author_facet | Xu, Jie Chen, Can Xiong, Jing Linghu, Hua |
author_sort | Xu, Jie |
collection | PubMed |
description | PURPOSE: To determine whether systemic lymphadenectomy exerts a similar effect on the survival of patients with either type I or type II endometrial cancer (EC). PATIENTS AND METHODS: In this retrospective study, 682 eligible patients diagnosed with EC were typed according to the pathological reports. The thoroughness of lymphadenectomy was evaluated by the lymph node number of which the cut-off value was determined by the receiver operator characteristic (ROC) curve and Youden index. The impact of thoroughness on the survival of both types was analyzed, respectively, by Kaplan Meier (K-M) method and further evaluated in subgroups with and without lymphatic metastasis. Independent prognostic factors of survival were selected by proportional hazard regression (Cox) model. RESULTS: The cut-off level of lymph node number was 20. The differential impact of the lymph node number removed on survival was noted when patients with different types were analyzed separately. Among type II EC, those with >20 lymph nodes removed presented better overall survival (OS) than those with ≤20 (p=0.002). The number of lymph nodes removed >20 was proved as an independent factor for improved OS in type II EC (HR=0.329,95% CI: 0.123–0.881, p=0.0027). In the subgroup of type II with >20 lymph nodes resected, similar 5-year OS rates were observed in those with or without identified positive node (90.9% vs 92.9%, p=0.965). Type I EC seemed unbeneficial from such a procedure. CONCLUSION: Systemic lymphadenectomy could enhance the OS of type II EC other than type I. |
format | Online Article Text |
id | pubmed-7721119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-77211192020-12-08 Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study Xu, Jie Chen, Can Xiong, Jing Linghu, Hua Cancer Manag Res Original Research PURPOSE: To determine whether systemic lymphadenectomy exerts a similar effect on the survival of patients with either type I or type II endometrial cancer (EC). PATIENTS AND METHODS: In this retrospective study, 682 eligible patients diagnosed with EC were typed according to the pathological reports. The thoroughness of lymphadenectomy was evaluated by the lymph node number of which the cut-off value was determined by the receiver operator characteristic (ROC) curve and Youden index. The impact of thoroughness on the survival of both types was analyzed, respectively, by Kaplan Meier (K-M) method and further evaluated in subgroups with and without lymphatic metastasis. Independent prognostic factors of survival were selected by proportional hazard regression (Cox) model. RESULTS: The cut-off level of lymph node number was 20. The differential impact of the lymph node number removed on survival was noted when patients with different types were analyzed separately. Among type II EC, those with >20 lymph nodes removed presented better overall survival (OS) than those with ≤20 (p=0.002). The number of lymph nodes removed >20 was proved as an independent factor for improved OS in type II EC (HR=0.329,95% CI: 0.123–0.881, p=0.0027). In the subgroup of type II with >20 lymph nodes resected, similar 5-year OS rates were observed in those with or without identified positive node (90.9% vs 92.9%, p=0.965). Type I EC seemed unbeneficial from such a procedure. CONCLUSION: Systemic lymphadenectomy could enhance the OS of type II EC other than type I. Dove 2020-11-30 /pmc/articles/PMC7721119/ /pubmed/33299347 http://dx.doi.org/10.2147/CMAR.S280780 Text en © 2020 Xu et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Xu, Jie Chen, Can Xiong, Jing Linghu, Hua Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title | Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title_full | Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title_fullStr | Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title_full_unstemmed | Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title_short | Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study |
title_sort | differential impact of systemic lymphadenectomy upon the survival of patients with type i vs type ii endometrial cancer: a retrospective observational cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721119/ https://www.ncbi.nlm.nih.gov/pubmed/33299347 http://dx.doi.org/10.2147/CMAR.S280780 |
work_keys_str_mv | AT xujie differentialimpactofsystemiclymphadenectomyuponthesurvivalofpatientswithtypeivstypeiiendometrialcanceraretrospectiveobservationalcohortstudy AT chencan differentialimpactofsystemiclymphadenectomyuponthesurvivalofpatientswithtypeivstypeiiendometrialcanceraretrospectiveobservationalcohortstudy AT xiongjing differentialimpactofsystemiclymphadenectomyuponthesurvivalofpatientswithtypeivstypeiiendometrialcanceraretrospectiveobservationalcohortstudy AT linghuhua differentialimpactofsystemiclymphadenectomyuponthesurvivalofpatientswithtypeivstypeiiendometrialcanceraretrospectiveobservationalcohortstudy |