Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study

Stefano Uccella, Francesca Falcone, Stefano Greggi, Francesco Fanfani, Pierandrea De Iaco, Giacomo Corrado, Marcello Ceccaroni, Vincenzo Dario Mandato, Stefano Bogliolo, Jvan Casarin, Giorgia Monterossi, Ciro Pinelli, Giorgia Mangili, Gennaro Cormio, Giovanni Roviglione, Alice Bergamini, Anna Pesci, Luigi Frigerio, Silvia Uccella, Enrico VizzaGiovanni Scambia, Fabio Ghezzi

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes.METHODS: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population.RESULTS: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively).CONCLUSION: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.
Original languageEnglish
Pages (from-to)e100
JournalJournal of Gynecologic Oncology
Volume29
Issue number6
DOIs
Publication statusPublished - Nov 1 2018

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Endometrial Neoplasms
Survival
Confidence Intervals
Recurrence
Mortality
Uterine Diseases
Gynecology
Obstetrics
Disease-Free Survival
Referral and Consultation
Lymph Nodes
Population

Keywords

  • Endometrial Cancer, Lymph Node Dissection, Prognosis

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Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study. / Uccella, Stefano; Falcone, Francesca; Greggi, Stefano; Fanfani, Francesco; De Iaco, Pierandrea; Corrado, Giacomo; Ceccaroni, Marcello; Mandato, Vincenzo Dario; Bogliolo, Stefano; Casarin, Jvan; Monterossi, Giorgia; Pinelli, Ciro; Mangili, Giorgia; Cormio, Gennaro; Roviglione, Giovanni; Bergamini, Alice; Pesci, Anna; Frigerio, Luigi; Uccella, Silvia; Vizza, Enrico; Scambia, Giovanni; Ghezzi, Fabio.

In: Journal of Gynecologic Oncology, Vol. 29, No. 6, 01.11.2018, p. e100.

Research output: Contribution to journalArticle

Uccella, S, Falcone, F, Greggi, S, Fanfani, F, De Iaco, P, Corrado, G, Ceccaroni, M, Mandato, VD, Bogliolo, S, Casarin, J, Monterossi, G, Pinelli, C, Mangili, G, Cormio, G, Roviglione, G, Bergamini, A, Pesci, A, Frigerio, L, Uccella, S, Vizza, E, Scambia, G & Ghezzi, F 2018, 'Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study', Journal of Gynecologic Oncology, vol. 29, no. 6, pp. e100. https://doi.org/10.3802/jgo.2018.29.e100
Uccella, Stefano ; Falcone, Francesca ; Greggi, Stefano ; Fanfani, Francesco ; De Iaco, Pierandrea ; Corrado, Giacomo ; Ceccaroni, Marcello ; Mandato, Vincenzo Dario ; Bogliolo, Stefano ; Casarin, Jvan ; Monterossi, Giorgia ; Pinelli, Ciro ; Mangili, Giorgia ; Cormio, Gennaro ; Roviglione, Giovanni ; Bergamini, Alice ; Pesci, Anna ; Frigerio, Luigi ; Uccella, Silvia ; Vizza, Enrico ; Scambia, Giovanni ; Ghezzi, Fabio. / Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study. In: Journal of Gynecologic Oncology. 2018 ; Vol. 29, No. 6. pp. e100.
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abstract = "OBJECTIVE: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes.METHODS: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population.RESULTS: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95{\%} confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95{\%} CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95{\%} CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95{\%} CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively).CONCLUSION: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.",
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TY - JOUR

T1 - Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study

AU - Uccella, Stefano

AU - Falcone, Francesca

AU - Greggi, Stefano

AU - Fanfani, Francesco

AU - De Iaco, Pierandrea

AU - Corrado, Giacomo

AU - Ceccaroni, Marcello

AU - Mandato, Vincenzo Dario

AU - Bogliolo, Stefano

AU - Casarin, Jvan

AU - Monterossi, Giorgia

AU - Pinelli, Ciro

AU - Mangili, Giorgia

AU - Cormio, Gennaro

AU - Roviglione, Giovanni

AU - Bergamini, Alice

AU - Pesci, Anna

AU - Frigerio, Luigi

AU - Uccella, Silvia

AU - Vizza, Enrico

AU - Scambia, Giovanni

AU - Ghezzi, Fabio

PY - 2018/11/1

Y1 - 2018/11/1

N2 - OBJECTIVE: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes.METHODS: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population.RESULTS: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively).CONCLUSION: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.

AB - OBJECTIVE: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes.METHODS: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population.RESULTS: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively).CONCLUSION: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.

KW - Endometrial Cancer, Lymph Node Dissection, Prognosis

U2 - 10.3802/jgo.2018.29.e100

DO - 10.3802/jgo.2018.29.e100

M3 - Article

VL - 29

SP - e100

JO - Journal of Gynecologic Oncology

JF - Journal of Gynecologic Oncology

SN - 2005-0380

IS - 6

ER -