İLERİ EVRE YÜKSEK GRADE ENDOMETRİUM KANSERLİ HASTALARDA SAĞKALIM SONUÇLARI
ÖzAmaç: İleri evre (FIGO III-IV) yüksek gradeli endometrium kanserli hastaların genel sağkalım ve hastalıksız sağkalımlarını değerlendirmek
SURVIVAL RESULTS OF PATIENTS WITH HIGH-GRADE AND ADVANCED-STAGE ENDOMETRIAL CANCER
Purpose: To evaluate the overall survival and disease-free survival in patients with advanced-stage(FIGO III-IV) and high-grade endometriumcancerPatients and Methods: Patients with operated due to endometrial cancer between 2003-2014 and detected FIGO-stage III-IV serous, clearcell,carcinosarcoma, mixed, grade 3 endometrioid, and undifferentiated histological types according to postoperative pathology reportwere selected for the study. Overall survival and disease-free survival times were calculated by Kaplan-Meier survival analysis for each histologictype.Results: A total of 85 patients with a median-age of 65(37-86) were included in the study. Of them, 56(65.9%) were stage-III and 29(34.1%)were stage-IV. The most common histological-type was carcinosarcoma(25.9%, n=22) followed by mixed(22.4%,n=19), serous(17.6%,n=18),grade 3 endometrioid(17.6% cell (8.2%,n=7) and undifferentiated(4.7%,n=4). During a mean follow-up of 37.1 months(1-148), 63 patients(74.1%) had recurrence and 60 patients(70.6%) died. The overall survival rate was 29.4%. The highest survival rates were mixed type andgrade 3 endometrioid types(42.1% and 40%) followed by serous(33.3%) and clear-cell(28.6%) and carcinosarcoma(13.6%) and no survival inundifferentiated type. Median disease-free survival and overall survival were 24 and 49 months for serous type, 28 and 34 months for grade3 endometrioid type, 15 and 27 months for mixed type, 9 and 18 months for clear cell, 10 and 21 months for carcinosarcoma, 3 and 4 monthsfor the undifferentiated typeConclusion: The median disease-free and overall survival of patients were 12 and 28 months, respectively, according to the data of thisstudy. 74.1% of the patients relapse. The worst prognosis is with undifferentiated types. The prognosis for Grade-3 endometrioid and mixedtypes seems to be relatively better.
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- 1. Gottwald L, Pluta P, Piekarski J, Spych M, Hendzel K,
Topczewska-Tylinska K, et al. Long-term survival of endometrioid
endometrial cancer patients. Arch Med Sci.
2010;6(6):937–44.
- 2. Reynaers EAEM, Ezendam NPM, Pijnenborg JMA.
Comparable outcome between endometrioid and nonendometrioid
tumors in patients with early-stage highgrade
endometrial cancer. J Surg Oncol. 2015;111(6):790–
4.
- 3. Oliva E, Soslow RA. High-Grade Endometrial Carcinomas.
Vol. 4, Surgical Pathology Clinics. 2011. p. 199–241.
- 4. Soslow RA. High-grade endometrial carcinomas - strategies
for typing. Vol. 62, Histopathology. 2013. p. 89–110.
- 5. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen
E, Vergote I. Endometrial cancer. Lancet (London,
England). 2005;366(9484):491–505.
- 6. Sorosky JI. Endometrial cancer. Obstet Gynecol.
2012;120(2 Pt 1):383–97.
- 7. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai
E. Endometrial cancer. In: The Lancet. 2016. p. 1094–108.
- 8. Lee NK. Adjuvant treatment of advanced-stage endometrial
cancer. Clin Obstet Gynecol. 2011;54(2):256–65.
- 9. Tangjitgamol S, See HT, Kavanagh J. Adjuvant chemotherapy
for endometrial cancer. Int J Gynecol Cancer.
2011;21(5):885–95.
- 10. Cantrell LA, Blank S V., Duska LR. Uterine carcinosarcoma:
A review of the literature. Vol. 137, Gynecologic
Oncology. 2015. p. 581–8.
- 11. Ferguson SE, Tornos C, Hummer A, Barakat RR, Soslow
RA. Prognostic features of surgical stage I uterine carcinosarcoma.
Am J Surg Pathol. 2007;31(11):1653–61.
- 12. Gokce ZK, Turan T, Karalok A, Tasci T, Ureyen I, Ozkaya
E, et al. Clinical outcomes of uterine carcinosarcoma: results
of 94 patients. Int J Gynecol Cancer. 2015;25(2):279–
87.
- 13. Vaidya AP, Horowitz NS, Oliva E, Halpern EF, Duska LR.
Uterine malignant mixed mullerian tumors should not be
included in studies of endometrial carcinoma. Gynecol
Oncol. 2006;103(2):684–7.
- 14. Roelofsen T, van Ham MAPC, Wiersma van Tilburg JM,
Zomer SF, Bol M, Massuger LFAG, et al. Pure Compared
With Mixed Serous Endometrial Carcinoma. Obstet
Gynecol. 2012;120(6):1371–81.
- 15. Espinosa I, D’Angelo E, Palacios J, Prat J. Mixed and
ambiguous endometrial carcinomas. Am J Surg Pathol.
2016;40(7):972–81.
- 16. Moore KN, Fader AN. Uterine papillary serous carcinoma.
Clin Obstet Gynecol. 2011;54(2):278–91.
- 17. Ayeni TA, Bakkum-Gamez JN, Mariani A, McGree ME,
Weaver AL, Haddock MG, et al. Comparative outcomes
assessment of uterine grade 3 endometrioid, serous, and
clear cell carcinomas. Gynecol Oncol. 2013;129(3):478–
85.
- 18. Felix AS, Stone RA, Bowser R, Chivukula M, Edwards
RP, Weissfeld JL, et al. Comparison of survival outcomes
between patients with malignant mixed mullerian
tumors and high-grade endometrioid, clear cell, and papillary
serous endometrial cancers. Int J Gynecol Cancer.
2011;21(5):877–84.
- 19. Hamilton C, Cheung M, Osann K, Chen L, Teng N,
Longacre T, et al. Uterine papillary serous and clear
cell carcinomas predict for poorer survival compared
to grade 3 endometrioid corpus cancers. Br J Cancer.
2006;94(5):642–6.
- 20. Greggi S, Mangili G, Scaffa C, Scala F, Losito S, Iodice F,
et al. Uterine papillary serous, clear cell, and poorly differentiated
endometrioid carcinomas: a comparative study.
Int J Gynecol Cancer. 2011;21(4):661–7.
- 21. Alkushi A, Köbel M, Kalloger SE, Gilks CB. High-Grade
Endometrial Carcinoma: Serous and Grade 3 Endometrioid
Carcinomas Have Different Immunophenotypes and
Outcomes. Int J Gynecol Pathol. 2010;29(4):343–50.