Impact of lymph node ratio on survival in stage IIIC endometrioid endometrial cancer: a Turkish Gynecologic Oncology Group study.
- Author:
Ali AYHAN
1
;
Nazlı TOPFEDAISI OZKAN
;
Murat ÖZ
;
Günsu KIMYON COMERT
;
Zeliha FIRAT CUYLAN
;
Gonca ÇOBAN
;
Osman TURKMEN
;
Baki ERDEM
;
Hanifi ŞAHIN
;
Ozgür AKBAYIR
;
Murat DEDE
;
Ahmet Taner TURAN
;
Husnu CELIK
;
Tayfun GÜNGÖR
;
Ali HABERAL
;
Macit ARVAS
;
Mehmet Mutlu MEYDANLI
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Survival Rate; Endometrioid Carcinoma; Endometrial Neoplasms; Lymph Node Excision; Disease-Free Survival
- MeSH: Carcinoma, Endometrioid; Diagnosis; Disease-Free Survival; Endometrial Neoplasms*; Female; Follow-Up Studies; Humans; Lymph Node Excision; Lymph Nodes*; Methods; Proportional Hazards Models; Retrospective Studies; Survival Rate; Turkey
- From:Journal of Gynecologic Oncology 2018;29(4):e48-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in women with stage IIIC endometrioid endometrial cancer (EC). METHODS: A multicenter, retrospective department database review was performed to identify patients with stage IIIC pure endometrioid EC at 6 gynecologic oncology centers in Turkey. A total of 207 women were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 2 groups: LNR1 (≤0.15), and LNR2 (>0.15). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. RESULTS: One hundred and one (48.8%) were classified as stage IIIC1 and 106 (51.2%) as stage IIIC2. The median age at diagnosis was 58 (range, 30–82) and the median duration of follow-up was 40 months (range, 1–228 months). There were 167 (80.7%) women with LNR ≤0.15, and 40 (19.3%) women with LNR >0.15. The 5-year progression-free survival (PFS) rates for LNR ≤0.15 and LNR >0.15 were 76.1%, and 58.5%, respectively (p=0.045). An increased LNR was associated with a decrease in 5-year overall survival (OS) from 87.0% for LNR ≤0.15 to 62.3% for LNR >0.15 (p=0.005). LNR >0.15 was found to be an independent prognostic factor for both PFS (hazard ratio [HR]=2.05; 95% confidence interval [CI]=1.07–3.93; p=0.03) and OS (HR=3.35; 95% CI=1.57–7.19; p=0.002). CONCLUSION: LNR seems to be an independent prognostic factor for decreased PFS and OS in stage IIIC pure endometrioid EC.
