Abstract
BackgroundEndometrial carcinoma is a common gynecological malignancy. Stage IV endometrial carcinoma is associated with a high risk of early death; however, there is currently no effective prognostic tool to predict early death in stage IV endometrial cancer.MethodsSurveillance, Epidemiology, and End Results (SEER) data from patients with stage IV endometrial cancer registered between 2004 and 2015 were used in this study. Important independent prognostic factors were identified by univariate and multivariate logistic regression analyses. A nomogram of all-cause and cancer-specific early deaths was constructed using relevant risk factors such as tumor size, histological grade, histological classification, and treatment (surgery, radiotherapy, chemotherapy).ResultsA total of 2,040 patients with stage IV endometrial carcinoma were included in this study. Of these, 299 patients experienced early death (≤3 months) and 282 died from cancer-specific causes. The nomogram of all-cause and cancer-specific early deaths showed good predictive power and clinical practicality with respect to the area under the receiver operating characteristic curve and decision curve analysis. The internal validation of the nomogram revealed a good agreement between predicted early death and actual early death.ConclusionsWe developed a clinically useful nomogram to predict early mortality from stage IV endometrial carcinoma using data from a large cohort. This tool can help clinicians screen high-risk patients and implement individualized treatment regimens.
Highlights
Endometrial carcinoma is the fourth most common gynecological malignancy in developed countries and the sixth leading cause of cancer death among women [1]
Of 4256 SEER database patients with endometrial carcinoma, 2,040 were included in the study based on the aforementioned inclusion and exclusion criteria
The majority of early deaths occurred in patients who were white (75%), between the ages of 56 and 74 years (55%), and insured (72%)
Summary
Endometrial carcinoma is the fourth most common gynecological malignancy in developed countries and the sixth leading cause of cancer death among women [1]. Subtype 1 (endometrioid endometrial carcinoma) accounts for approximately 80% of endometrial. Death From Endometrial Carcinoma cancers; it is diagnosable in early stages and has a good prognosis. Subtype 2 (non-endometrioid endometrial carcinoma) accounts for approximately 20% of endometrial carcinomas, is highly invasive, and has a poor prognosis [5]. Most patients with endometrial carcinoma are diagnosed at an early stage of the disease, and the 5-year survival rate is relatively high (65.27%– 81.2%) [6, 7]. In a study by Tai et al, the survival of patients with stage IV endometrial cancer was found to be significantly poor, with the median progression-free survival and overall survival being 3.8 and 12.3 months, respectively [9]. Stage IV endometrial carcinoma is associated with a high risk of early death; there is currently no effective prognostic tool to predict early death in stage IV endometrial cancer
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