Lower Uterine Segment Involvement as a Predictor for Poor Prognosis in Patients Receiving Adjuvant Radiotherapy for Stage I Endometrial Carcinoma
10.3969/j.issn.1674-9081.2016.04.002
- VernacularTitle:子宫下段受累可能为Ⅰ期内膜癌辅助放疗的不良预后因素
- Author:
Xiao-Rong HOU
1
;
Ke HU
;
Jie SHEN
;
Xin LIAN
;
Shuai SUN
;
Jun-Fang YAN
;
Zhi-Kai LIU
;
Fu-Quan ZHANG
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院放射治疗科
- Keywords:
endometrial carcinoma;
postoperative radiotherapy;
lower uterine segment involvement;
high-intermediate risk;
prognostic factor
- From:
Medical Journal of Peking Union Medical College Hospital
2016;7(4):246-252
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of lower uterine segment involvement (LUSI) in predicting the prognosis of stageⅠendometrial carcinoma patients treated with postoperative radiotherapy .Methods The data of a total of 265 patients with stage Ⅰendometrial carcinoma treated with hysterectomy and adjuvant radiotherapy be -tween January 1999 and December 2012 were retrospectively analyzed .The median age of the cohort was 53 years.The most common pathological type was endometrioid adenocarcinoma (226/265, 85.3%).The patients were divided into two groups according to the presence of LUSI:LUSI group and non-LUSI group .The prognostic factors and treatment outcomes were compared between the two groups , subgroup analysis was conducted in the high-risk and high-intermediate-risk patients in the two groups .Primary outcomes were overall survival ( OS), progression-free survival ( PFS) , loco-regional recurrence ( LR) , distant metastasis ( DM) , and treatment failure (TF).The survival rates were calculated using the Kaplan-Meier method.The survival rates between different groups were compared using the Log-rank test .Prognostic factors for survival were analyzed using a Cox propor-tional hazards regression model .Results The 5-year OS and PFS for all the patients were 92.8%and 89.7%, respectively;the 5-year LR, DM, and TF were 4.5%, 6.4%, and 7.8%, respectively .Univariate analysis re-vealed that LUSI was a significant predictor of OS and PFS ( P=0.015 , 0.035 ) .Cox proportional hazard model demonstrated a significantly decreased OS and PFS in the LUSI group compared with the non -LUSI group ( P=0.041 , RR=0.346 , 95%CI:0.125-0.959;P=0.041 , RR=0.411 , 95%CI:0.175-0.963 ) .Subgroup univariate analysis showed that for high-risk and high-intermediate-risk patients, LUSI was a significant predictor of TF ( P=0.034 ) .Conclusions LUSI may be a significant predictor of reduced OS and PFS in patients with stage Ⅰ endometrial carcinoma treated with adjuvant radiotherapy .In addition, LUSI may be associated with treatment failure in high-risk and high-intermediate-risk patients .
