Our objectives were to determine the most significant prognostic factors affecting node metastasis in endometrial cancer and to devise and validate a scoring system for endometrial cancer. The study design consisted of retrospective chart review (operative record and histopathology report) of all endometrial cancer patients who underwent total hysterectomy/radical hysterectomy, bilateral salpingooophorectomy, bilateral pelvic lymph node dissection and peritoneal fluid cytology from September 21, 1989 to February 19, 1999. The analysis included 262 women, 21.4% of whom had pelvic lymph node metastasis.The mean ages for those with metastasis and without metastasis were similar positive lymph node (LN) =53.18 years old; negative LN=51.89 years old; range: positive LN=31-84 years old, negative LN=23-76 years old. Most patients were of low gravidity, with mean=G3, median=G4, mode = GO. The most significant factors affecting pelvic lymph node metastasis were peritoneal fluid cytology, myometrial invasion, cervix involvement and histologic grade as determined by logistic regression and Odds ratio. A prognostic scoring system was devised. All subjects were scored according to a proposed scoring system to determine the latter's clinical utility. A cut-off score of 5 was shown to be significant for pelvic lymph node metastasis. The proposed scoring system may be used to determine the likelihood of pelvic lymph node metastasis for patients who did not have lymphadenectomy and may have an important role in determining the need for adjuvant treatment.

Ascitic Fluid ; Prognosis ; Gravidity ; Lymph Node Excision ; Endometrial Neoplasms ; Lymphatic Metastasis ; Lymph Nodes ; Hysterectomy

Background: Even though innumerable quality of life (QOL) questionnaires have been developed in palliative care, there is no gold standard assessment tool for QOL and no single questionnaire that fits all purposes and individuals. An important challenge to QOL assessments in palliative care is the highly diverse patient population with different diagnoses, disease states/prognosis, and languages. In an outpatient palliative care clinic population, FACIT-Pal-14 proved to be a valid and reliable scale in palliative care patients. Objectives: We aimed to (i) determine the psychometric properties of the Tagalog version of the Functional Assessment of Chronic Illness Therapy – Palliative Care – 14 (FACIT-Pal-14) and (ii) measure the Quality of Life (QOL) of Filipino cancer patients. Methods: This was a cross-sectional study. License for the use of the Tagalog version 4 of the FACIT-Pal-14 was requested from FACIT.org. To know the psychometric properties of the scales, Cronbach’s alpha coefficient was used to assess reliability, and exploratory factor analysis, Pearson correlations, and independent samples T-test were used to determine validity. Results: The Tagalog FACIT-Pal-14 was administered to 500 Filipino cancer patients consulting at the outpatient department of a training and regional medical center. The participants were mostly female (65.5%), aged 64 years and younger (82.6%), and had breast cancer (53.2%), colorectal cancer (19.2%), and lung cancer (9.4%). The mean Tagalog FACIT-Pal-14 score was 47.35 out of 56 (SD=7.14). The Cronbach's alpha coefficient of the Tagalog version of FACIT-Pal-14 was 0.784. Significantly lower mean Tagalog FACIT-Pal-14 scores were found in patients with Karnofsky Performance Status (KPS) 70 and lower, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 2 and above compared with patients with KPS 80 and higher and ECOG-PS 0-1. (t=3.439, p<.001). While the Tagalog FACIT-Pal-14 scores, KPS, and ECOG scores only revealed a very weak, positive correlation (r=0.095; p <0.05), this ability to distinguish between groups known to differ regarding performance status showed the construct validity of the Tagalog FACIT-Pal-14. Conclusions In an outpatient oncology clinic population, the FACIT-Pal 14 showed evidence of reliability and construct validity for evaluating palliative care-specific QOL in Filipino cancer patients. Using this measure, Filipino cancer patients have a good QOL. Therefore, it is recommended that the Tagalog FACIT-Pal-14 be used on subsequent patient follow-ups to assess how their QOL would change over time so that the palliative care services provided will be suited to their needs.
Quality of Life