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Risk Factors and Prognosis of Early Recurrence in Stage I-II Endometrial Cancer: A Large-Scale, Multi-Center, and Retrospective Study

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单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Key Lab Minist Educ,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Gynecol & Obstet,Wuhan,Peoples R China [3]Shandong Univ, Qilu Hosp, Cheeloo Coll Med, Dept Obstet & Gynecol, Jinan, Peoples R China [4]Zhejiang Univ, Womens Hosp, Sch Med, Hangzhou, Peoples R China [5]Sun Yat Sen Univ, Dept Gynecol Oncol, Canc Ctr, Guangzhou, Peoples R China [6]Sun Yat Sen Univ, Affiliated Hosp 1, Dept Obstet & Gynecol, Guangzhou, Peoples R China [7]Fudan Univ, Dept Gynecol, Obstet & Gynecol Hosp, Shanghai, Peoples R China [8]Qingdao Univ, Dept Gynecol & Obstet, Affiliated Yantai Yuhuangding Hosp, Yantai, Peoples R China [9]Harbin Med Univ, Dept Gynecol Oncol, Canc Hosp, Harbin, Peoples R China [10]China Med Univ, Dept Obstet & Gynecol, Shengjing Hosp, Shenyang, Peoples R China [11]Peking Univ Peoples Hosp, Dept Gynecol, Beijing, Peoples R China [12]Univ Sci & Technol China, Affiliated Hosp USTC 1, Div Life Sci & Med, Hefei, Peoples R China [13]Guangxi Med Univ, Dept Gynecol Oncol, Canc Hosp, Nanning, Peoples R China [14]Nanjing Med Univ, Dept Gynecol, Affiliated Hosp 1, Nanjing, Peoples R China [15]Third Hosp Peking Univ, Beijing, Peoples R China [16]Zhengzhou Univ, Dept Gynecol & Obstet, Affiliated Hosp 1, Zhengzhou, Peoples R China [17]Tianjin Med Univ Gen Hosp, Dept Gynecol & Obstet, Tianjin, Peoples R China [18]Shanghai Jiao Tong Univ, Xinhua Hosp, Dept Gynecol & Obstet, Sch Med, Shanghai, Peoples R China [19]Peoples Hosp Xinjiang Uygur Autonomous Reg, Dept Gynecol, Urumqi, Peoples R China [20]Sichuan Univ, West China Hosp 2, Dept Gynecol & Obstet, Dev & Related Dis Women & Children Key Lab Sichuan, Chengdu, Peoples R China [21]Sun Yat sen Univ, Affiliated Hosp 3, Dept Gynecol & Obstet, Guangzhou, Peoples R China [22]Shandong Univ, Dept Gynecol, Hosp 2, Jinan, Peoples R China [23]Nankai Univ, Tianjin Cent Hosp Gynecol & Obstet, Dept Gynecol Oncol, Affiliated Hosp, Tianjin, Peoples R China [24]Tianjin Clin Res Ctr Gynecol & Obstet, Branch Natl Clin Res Ctr Gynecol & Obstet, Dept Gynecol Oncol, Tianjin, Peoples R China [25]Cent South Univ, Xiangya Hosp 3, Dept Obstet & Gynecol, Changsha, Peoples R China
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关键词: endometrial cancer recurrence pattern early recurrence clinical features risk factors

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ObjectiveThe aim of the present study was to determine overall survival (OS) and risk factors associated with early recurrence in patients with FIGO I-II stage endometrial carcinoma (EC). MethodsClinical features were retrospectively extracted from the database of China Endometrial Cancer Consortium from January 2000 to December 2019. A total of 2,974 patients with Federation International of Gynecology and Obstetrics (FIGO) I-II stage endometrial cancer were included. Kaplan-Meier survival analysis was used to assess OS and disease-specific survival. Cox proportional hazard model and Fine-Gray model were used to determine the factors related to OS. Binary logistic regression model was used to determine independent predictors of early relapse patients. ResultsOf these 2,974 ECs, 189 patients were confirmed to have relapse. The 5-year OS was significantly different between the recurrence and non-recurrence patients (p < 0.001). Three quarters of the relapse patients were reported in 36 months. The 5-year OS for early recurrence patients was shorter than late recurrence [relapse beyond 36 months, p < 0.001]. The grade 3 [odds ratio (OR) = 1.55, 95%CI 1.17-2.05, p = 0.002], lymphatic vascular infiltration (LVSI; OR = 3.36; 95%CI 1.50-7.54, p = 0.003), and myometrial infiltration (OR = 2.07, 95%CI 1.17-3.65, p = 0.012) were independent risk factors of early relapse. The protective factor of that is progesterone receptor (PR)-positive (OR = 0.50, 95%CI 0.27-0.92, p = 0.02). Bilateral ovariectomy could reduce recurrence risk rate (OR = 0.26, 95%CI 0.14-0.51, p < 0.001). ConclusionThe OS of early relapse EC is worse. Grade 3, LVSI, and myometrial infiltration are independent risk factors for early relapse EC. In addition, the protective factor is PR-positive for those people and bilateral salpingo-oophorectomy could reduce the risk of recurrence.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 2 区 医学:内科
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2020]版:
Q1 MEDICINE, GENERAL & INTERNAL
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Q1 MEDICINE, GENERAL & INTERNAL

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第一作者单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Key Lab Minist Educ,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Gynecol & Obstet,Wuhan,Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Canc Biol Res Ctr,Key Lab Minist Educ,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Gynecol & Obstet,Wuhan,Peoples R China
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