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Stratification of risk groups according to survival after recurrence in endometrial cancer patients.

Abstract To identify prognostic factors for overall survival after recurrence (OSr) in endometrioid endometrial cancer (EC) patients and categorize patient subgroups that predict outcomes using these variables.Consecutive patients with recurrent endometrioid EC seen in our institution from 1989 to 2013 were retrospectively reviewed. Cox regression models were used to identify the clinicopathological factors associated with OSr. By summing scores proportionate to the hazard ratio (HR) for each significant variable, we stratified patients into 3 risk groups.Enrolled patients (n = 108) had a median time to recurrence of 15 (range, 3-163) months after initial treatment and a median OSr of 22 (range, 1-207) months. Twenty patients (18.5%) had locoregional recurrence, and 88 (81.5%) distant. One hundred three patients underwent salvage therapy; 51 (47.2%) received chemotherapy only, 22 (20.3%) received radiotherapy either alone or combined with chemotherapy, and 29 (26.9%) underwent salvage cytoreductive surgery. Multivariate regression analysis revealed that time to relapse after initial treatment, cancer antigen-125 level at recurrence, and the number of recurrent lesions were independent predictors of OSr. Incorporating these factors, we stratified patients into low-risk (n = 19), intermediate-risk (n = 43), and high-risk (n = 46) groups. The likelihood of cancer-specific death was higher in both the high-risk (HR = 8.948, 95% confidence interval [CI] = 3.498-22.893, P < .001) and the intermediate-risk (HR = 2.619, 95% CI = 1.002-6.850, P = .05) groups compared with the low-risk group.Incorporating 3 variables, recurrent endometrioid EC patients with a broad spectrum of outcome could be stratified according to OSr. This model may help predict outcomes in recurrent EC patients.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28538383
OWN - NLM
STAT- MEDLINE
DA  - 20170524
DCOM- 20170612
LR  - 20170612
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 21
DP  - 2017 May
TI  - Stratification of risk groups according to survival after recurrence in
      endometrial cancer patients.
PG  - e6920
LID - 10.1097/MD.0000000000006920 [doi]
AB  - To identify prognostic factors for overall survival after recurrence (OSr) in
      endometrioid endometrial cancer (EC) patients and categorize patient subgroups
      that predict outcomes using these variables.Consecutive patients with recurrent
      endometrioid EC seen in our institution from 1989 to 2013 were retrospectively
      reviewed. Cox regression models were used to identify the clinicopathological
      factors associated with OSr. By summing scores proportionate to the hazard ratio 
      (HR) for each significant variable, we stratified patients into 3 risk
      groups.Enrolled patients (n = 108) had a median time to recurrence of 15 (range, 
      3-163) months after initial treatment and a median OSr of 22 (range, 1-207)
      months. Twenty patients (18.5%) had locoregional recurrence, and 88 (81.5%)
      distant. One hundred three patients underwent salvage therapy; 51 (47.2%)
      received chemotherapy only, 22 (20.3%) received radiotherapy either alone or
      combined with chemotherapy, and 29 (26.9%) underwent salvage cytoreductive
      surgery. Multivariate regression analysis revealed that time to relapse after
      initial treatment, cancer antigen-125 level at recurrence, and the number of
      recurrent lesions were independent predictors of OSr. Incorporating these
      factors, we stratified patients into low-risk (n = 19), intermediate-risk (n =
      43), and high-risk (n = 46) groups. The likelihood of cancer-specific death was
      higher in both the high-risk (HR = 8.948, 95% confidence interval [CI] =
      3.498-22.893, P &lt; .001) and the intermediate-risk (HR = 2.619, 95% CI =
      1.002-6.850, P = .05) groups compared with the low-risk group.Incorporating 3
      variables, recurrent endometrioid EC patients with a broad spectrum of outcome
      could be stratified according to OSr. This model may help predict outcomes in
      recurrent EC patients.
FAU - Shim, Seung-Hyuk
AU  - Shim SH
AD  - aDepartment of Obstetrics and Gynecology, Konkuk University School of Medicine
      bDepartment of Obstetrics and Gynecology, University of Ulsan College of
      Medicine, Asan Medical Center, Seoul, Korea.
FAU - Kim, Dae-Yeon
AU  - Kim DY
FAU - Kim, Hyun Jung
AU  - Kim HJ
FAU - Lee, Shin-Wha
AU  - Lee SW
FAU - Park, Jeong-Yeol
AU  - Park JY
FAU - Suh, Dae-Shik
AU  - Suh DS
FAU - Kim, Jong-Hyeok
AU  - Kim JH
FAU - Kim, Yong-Man
AU  - Kim YM
FAU - Kim, Young-Tak
AU  - Kim YT
FAU - Nam, Joo-Hyun
AU  - Nam JH
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Endometrial Neoplasms/*diagnosis/therapy
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Recurrence, Local/*diagnosis/therapy
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk
MH  - Young Adult
PMC - PMC5457863
EDAT- 2017/05/26 06:00
MHDA- 2017/06/13 06:00
CRDT- 2017/05/25 06:00
AID - 10.1097/MD.0000000000006920 [doi]
AID - 00005792-201705260-00024 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 May;96(21):e6920. doi: 10.1097/MD.0000000000006920.

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