Abstract
Background: to elucidate the predictors of progression-free survival (PFS) and overall survival (OS) in high-risk endometrial cancer patients. Methods: the medical records of all consecutivewomen with high-risk endometrial cancer were reviewed. Results: among 92 high-risk endometrial cancer patients, 30 women experienced recurrence, and 21 women died. The 5-year PFS and OS probabilities were 65.3% and 75.9%, respectively. Multivariable Cox regression revealed that body mass index (hazard ratio (HR) = 1.11), paraaortic lymph node metastasis (HR = 11.11), lymphovascular space invasion (HR = 5.61), and sandwich chemoradiotherapy (HR = 0.15) were independently predictors of PFS. Body mass index (HR = 1.31), paraaortic lymph node metastasis (HR = 32.74), non-endometrioid cell type (HR = 11.31), and sandwich chemoradiotherapy (HR = 0.07) were independently predictors of OS. Among 51 women who underwent sandwich (n = 35) or concurrent (n = 16) chemoradiotherapy, the use of sandwich chemoradiotherapy were associated with better PFS (adjusted HR = 0.26, 95% CI = 0.08–0.87, p = 0.03) and OS (adjusted HR = 0.11, 95% CI = 0.02–0.71, p = 0.02) compared with concurrent chemoradiotherapy. Conclusion: compared with concurrent chemoradiotherapy, sandwich chemoradiotherapy was associated with better PFS and OS in high-risk endometrial cancer patients. In addition, high body mass index, paraaortic lymph node metastasis, and non-endometrioid cell type were also predictors of poor OS in high-risk endometrial cancer patients.
Highlights
The incidence of endometrial cancer (EC) is currently increasing, and most women with EC have a good prognosis
progression-free survival (PFS) probability were 65.3% (95% confidence interval (CI) = 54.1–74.4%) and 65.3%, respectively
The use of sandwich CRT was associated with better PFS and overall survival (OS), compared with concurrent CRT
Summary
The incidence of endometrial cancer (EC) is currently increasing, and most women with EC have a good prognosis. Some women with high-risk EC have an increased risk for recurrence [1]. High-risk EC can be identified according to the presence of one of the following: (1) International. Federation of Gynecology and Obstetrics (FIGO) 2009 stage I, endometrioid grade 3 cancer with deep myometrial invasion, lymphovascular space invasion, or both; (2) stage II or III disease; or (3) stage. I-III disease with serous or clear cell histology [2]. Res. Public Health 2020, 17, 5941; doi:10.3390/ijerph17165941 www.mdpi.com/journal/ijerph
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