Evaluation of the role of liver metastasectomy in the treatment of stage IV endometrial cancer.

IF 3.4 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of Gynecologic Oncology Pub Date : 2025-02-11 DOI:10.3802/jgo.2025.36.e79

Xavier L Baldwin, Jihye Park, Joyce Pak, Leslie H Clark, Hong Jin Kim, Michael T LeCompte

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引用次数: 0

Abstract

Objective: Hepatic metastasectomy for gynecologic cancers remains controversial. Management of advanced endometrial cancer (EC) is complex. The purpose of this study is to analyze the efficacy of liver metastasectomy (LM) in the treatment of metastatic EC.

Methods: The National Cancer Database was used to create a retrospective cohort of adult women with EC metastatic to the liver between 2010 and 2016. Overall survival and all-cause mortality were estimated with inverse probability of treatment weighting (IPTW) curves and IPTW Cox proportional hazard regression, respectively.

Results: Among 999 EC patients with oligometastatic disease to the liver, 162 (16.2%) underwent LM, 614 (61.5%) received chemotherapy, and 129 (12.9%) had chemotherapy and LM. Those who underwent chemotherapy, 1-, 2-, and 3-year survival for chemotherapy + LM versus chemotherapy alone were 67.8 versus 56.5%, 44.9 versus 33.4%, and 35.1 versus 23.1%, respectively. In unadjusted analysis, chemotherapy + LM group had reduced mortality risk (hazard ratio [HR]=0.68; 95% confidence interval [CI]=0.54-0.86) with longer median survival time (20.1 vs. 14.6 months, p=0.011) compared to chemotherapy alone. Adjusting for demographics and treatment characteristics, a possible reduction in mortality was associated with chemotherapy + LM (HR=0.74; 95% CI=0.55-1.01) compared to chemotherapy alone.

Conclusion: This study of LM for EC suggests LM in addition to chemotherapy may be associated with improved outcomes for patients with EC.

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肝转移切除术在IV期子宫内膜癌治疗中的作用评价。

目的：妇科肿瘤肝转移切除术仍有争议。晚期子宫内膜癌（EC）的治疗是复杂的。本研究的目的是分析肝转移切除术（LM）治疗转移性肝癌的疗效。方法：使用国家癌症数据库创建2010年至2016年期间EC转移到肝脏的成年女性回顾性队列。总生存率和全因死亡率分别用治疗加权逆概率（IPTW）曲线和IPTW Cox比例风险回归估计。结果：999例伴有肝少转移的EC患者中，行肝移植162例（16.2%），化疗614例（61.5%），化疗合并肝移植129例（12.9%）。接受化疗的患者，化疗+ LM与单独化疗的1年、2年和3年生存率分别为67.8比56.5%，44.9比33.4%，35.1比23.1%。未经校正分析，化疗+ LM组死亡风险降低(危险比[HR]=0.68；95%可信区间[CI]=0.54-0.86)，中位生存时间（20.1个月对14.6个月，p=0.011）较单独化疗更长。调整人口统计学和治疗特征后，化疗+ LM可能降低死亡率(HR=0.74；95% CI=0.55-1.01)。结论：LM治疗EC的研究表明，在化疗的基础上进行LM治疗可能会改善EC患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.00

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.