TY - JOUR
T1 - Exploring metastasis and recurrence patterns in low-risk grade 3 endometrial cancer
T2 - A multicenter retrospective cohort study
AU - Aiob, Ala
AU - Lee, Kwang Beom
AU - Kim, Se Ik
AU - Kim, Nam Kyeong
AU - Kang, Sokbom
AU - Lee, Chae Hyeong
AU - Jeong, Dae Hoon
AU - Lee, Banghyun
AU - Kim, Kidong
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/10
Y1 - 2024/10
N2 - Objective: Females with low-risk endometrial cancer typically have low lymph node metastasis risk and promising prognosis without lymphadenectomy. However, the impact of grade 3 endometrial cancer on nodal involvement, recurrence, and prognosis within this specific subgroup remains unclear. Therefore, in this study, we aimed to investigate the prognosis, patterns of metastasis, and recurrence in a subgroup of females with grade 3 early-stage low-risk endometrioid endometrial cancer. Methods: We identified patients from the endometrial cancer cohorts of seven institutional hospitals. The study included patients who underwent hysterectomy between January 2013 and December 2021 with preoperative endometrioid histological type, less than half myometrial invasion, no tumor spread outside the corpus on imaging, normal CA-125 level, and histological grade 3. The clinicopathological characteristics and survival outcomes of the patients were collected. Recurrence-free survival was estimated using the Kaplan–Meier method and compared using the log rank test. Results: Overall, 36 patients were included in this analysis. Of the 33 patients who underwent lymphadenectomy, 1 (1/33, 3.0 %) had lymph node metastasis and 27 (75.0 %) received adjuvant therapy. At a median follow-up of 58 months, three females (8 %) had recurrence and all cases involved lymph nodes. The 5-year recurrence-free survival was 88.7 %. No significant difference was observed in the recurrence-free survival between females who did and did not undergo lymphadenectomy (p = 0.554). Conclusion: Females diagnosed with low-risk grade 3 endometrial cancer typically have favorable prognosis. However, lymph node metastasis and recurrence risks still exist, with all recorded instances of recurrence involving lymph nodes.
AB - Objective: Females with low-risk endometrial cancer typically have low lymph node metastasis risk and promising prognosis without lymphadenectomy. However, the impact of grade 3 endometrial cancer on nodal involvement, recurrence, and prognosis within this specific subgroup remains unclear. Therefore, in this study, we aimed to investigate the prognosis, patterns of metastasis, and recurrence in a subgroup of females with grade 3 early-stage low-risk endometrioid endometrial cancer. Methods: We identified patients from the endometrial cancer cohorts of seven institutional hospitals. The study included patients who underwent hysterectomy between January 2013 and December 2021 with preoperative endometrioid histological type, less than half myometrial invasion, no tumor spread outside the corpus on imaging, normal CA-125 level, and histological grade 3. The clinicopathological characteristics and survival outcomes of the patients were collected. Recurrence-free survival was estimated using the Kaplan–Meier method and compared using the log rank test. Results: Overall, 36 patients were included in this analysis. Of the 33 patients who underwent lymphadenectomy, 1 (1/33, 3.0 %) had lymph node metastasis and 27 (75.0 %) received adjuvant therapy. At a median follow-up of 58 months, three females (8 %) had recurrence and all cases involved lymph nodes. The 5-year recurrence-free survival was 88.7 %. No significant difference was observed in the recurrence-free survival between females who did and did not undergo lymphadenectomy (p = 0.554). Conclusion: Females diagnosed with low-risk grade 3 endometrial cancer typically have favorable prognosis. However, lymph node metastasis and recurrence risks still exist, with all recorded instances of recurrence involving lymph nodes.
KW - Endometrial cancer
KW - Endometrioid carcinoma
KW - Lymph node dissection
KW - Recurrence-free survival
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=85201094082&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2024.08.014
DO - 10.1016/j.ejogrb.2024.08.014
M3 - Article
C2 - 39137594
AN - SCOPUS:85201094082
SN - 0301-2115
VL - 301
SP - 154
EP - 159
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
ER -