早期低分化子宫内膜样内膜癌淋巴管间隙侵犯的预后意义:一项为期十五年的中国队列回顾性研究。

IF 2.5 3区 医学 Q3 ONCOLOGY
Bowen Sun, Xiaobo Zhang, Yangyang Dong, Xingchen Li, Xiao Yang, Lijun Zhao, Jianliu Wang, Yuan Cheng
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引用次数: 0

摘要

目的:2016 年,ESMO-ESGO-ESTRO 共识将 LVSI(淋巴-血管间隙侵犯,LVSI)状态作为 I 期子宫内膜样内膜癌(EEC)患者的风险分层因素,并作为辅助治疗的适应症之一。此外,LVSI 已被纳入 2023 年新的 FIGO 子宫内膜癌(EC)分期。然而,中国人群在这方面的数据贡献有限。本研究旨在通过一项为期15年的回顾性中国队列研究,进一步证实LVSI对早期低分化子宫内膜癌预后的影响:该回顾性队列研究纳入了2006-2020年间在北京大学人民医院接受TAH/BSO手术、全腹子宫切除术、双侧输卵管切除术的702例EEC患者。根据 LVSI 表达状态将患者分层为:LVSI 阴性组和 LVSI 阳性组:LVSI阴性组和LVSI阳性组。采用单变量和多变量考克斯比例危险回归模型评估与LVSI相关的临床结局指标:分析了 702 例 I 期和 1-2 级 EEC 患者。58例患者(8.3%)LVSI阳性,14例患者(2.0%)复发。LVSI阴性和LVSI阳性患者的复发率分别为1.6%和6.9%。LVSI阴性和LVSI阳性患者的5年无病生存率分别为98.4%和93.1%。LVSI阴性患者的5年总生存率为98.9%,而LVSI阳性患者的5年总生存率为94.8%。多变量分析显示,LVSI是5年DFS的独立危险因素(HR = 4.60,P = 0.010)。结论:结论:LVSI是中国人群中早期低分化子宫内膜样内膜癌复发和预后不良的独立预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic significance of lymphovascular space invasion in early-stage low-grade endometrioid endometrial cancer: a fifteen-year retrospective Chinese cohort study.

Objective: In 2016, the ESMO-ESGO-ESTRO consensus included LVSI (Lymph-vascular space invasion, LVSI) status as a risk stratification factor for stage I endometrioid endometrial cancer (EEC) patients and as one of the indications for adjuvant therapy. Furthermore, LVSI is included in the new FIGO staging of endometrial cancer (EC) in 2023. However, the data contribution of the Chinese population in this regard is limited. The present study aimed to further comfirm the influence of LVSI on the prognosis of early-stage low-grade EEC in a fifteen-year retrospective Chinese cohort study.

Methods: This retrospective analysis cohort included 702 EEC patients who underwent TAH/BSO surgery, total abdominal hysterectomy, bilateral salpingooophorectomy in Peking University People's Hospital from 2006 to 2020. Patients were stratified based on LVSI expression status as: LVSI negative group and LVSI positive group. Clinical outcome measures related to LVSI, assessed with a univariate and multivariate Cox proportional hazards regression model.

Results: 702 EEC patients with stage I and grade 1-2 were analyzed. 58 patients (8.3%) were LVSI-positive and 14 patients (2.0%) was relapse. Recurrence rates in LVSI-negative and LVSI-positive were 1.6% and 6.9%, respectively. 5-year disease-free survival (DFS) rate in LVSI-negative and LVSI-positive were 98.4% and 93.1%, respectively. These rates for 5-year overall (OS) survival in LVSI-negative were 98.9% while it was 94.8% in LVSI-positive. Multivariate analysis showed that LVSI is an independent risk factor for 5-year DFS (HR = 4.60, p = 0.010). LVSI has a similar result for 5-year OS(HR = 4.39, p = 0.028).

Conclusions: LVSI is an independent predictor of relapse and poor prognosis in early-stage low-grade endometrioid endometrial cancer in the Chinese cohort.

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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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