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Analysis of stage IVB endometrial carcinoma patients with distant metastasis: a review of prognoses in 55 patients

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Abstract

Background

Adequate treatment for extremely advanced endometrial cancer is unknown. The purpose of this study was to clarify the prognosis of patients with stage IVB endometrial carcinoma and the validity of treatment. Furthermore, we evaluated whether there was a connection between the prognosis and the site of metastasis.

Methods

The prognoses of 55 patients with stage IVB endometrial carcinoma were studied with reference to the initial treatment method and the metastatic site at the time of the initial treatment.

Results

The median survivals of the group of 35 patients who were initially treated with surgery and the group of 10 patients who underwent radiotherapy or chemotherapy as their initial treatment followed by surgery were 11.5 months and 9.5 months, respectively. The residual tumor diameter after surgery was precisely measured in 40 of these 45 patients. The prognosis was significantly better in the patients with a residual tumor diameter of less than 2 cm compared to those with a tumor diameter of 2 cm or greater, and the median survival periods in these two groups were 23.5 months and 11.5 months, respectively (P = 0.027). Furthermore, the prognosis of patients with lung metastasis was significantly better than that of patients with non-lung hematogenous metastasis; the median survival periods of these two groups were 18.5 months and 10.5 months, respectively (P = 0.014).

Conclusion

For operable patients, surgery as an initial treatment and reduction of the residual tumor size to less than 2 cm appeared to contribute to a better prognosis. In addition, conservative initial treatment and the presence of non-lung hematogenous metastasis were poor prognostic factors.

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References

  1. Landis SH, Murray T, Bolden S, et al. (1999) Cancer statistics 1999. CA Cancer J Clin 49:8–31

    Article  PubMed  CAS  Google Scholar 

  2. Pecorrelli S, Creasman WT, Pettersson F, et al. (1998) FIGO annual report on the results of treatment in gynecologic cancer. J Epidemiol Biostat 3:35–62

    Google Scholar 

  3. Wolfson AH, Sightler SE, Markoe AM, et al. (1992) The prognostic significance of surgical staging for carcinoma of the endometrium. Gynecol Oncol 45:142–146

    Article  PubMed  CAS  Google Scholar 

  4. Marino BD, Burke TW, Tornos C, et al. (1995) Staging laparotomy for endometrial carcinoma. Assessment of peritoneal spread. Gynecol Oncol 56:34–38

    Article  CAS  Google Scholar 

  5. Vardi JR, Tadros GH, Anselmo MT, et al. (1992) The value of exploratory laparotomy in patients with endometrial carcinoma according to the new International Federation of Gynecology and Obstetrics staging. Obstet Gynecol 80:204–208

    PubMed  CAS  Google Scholar 

  6. Goff BA, Goodman A, Muntz HG, et al. (1994) Surgical IV endometrial carcinoma: a study of 47 patients. Gynecol Oncol 52: 237–240

    Article  PubMed  CAS  Google Scholar 

  7. Chi DS, Welshinger M, Verkatraman RR (1997) The role of surgical cytoreduction in stage IV endometrial carcinoma. Gynecol Oncol 67:56–60

    Article  PubMed  CAS  Google Scholar 

  8. Bristow RE, Zerbe MJ, Rosenshein NB, et al. (2000) Stage IVB endometrial carcinoma: the role of cytoreductive surgery and determinants of survival. Gynecol Oncol 78:85–91

    Article  PubMed  CAS  Google Scholar 

  9. Kaplan EL, Meier P (1958) Non-parametric estimation for incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  10. Mantel N (1966) Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 50:163–170

    PubMed  CAS  Google Scholar 

  11. Snedecor GW, Cochran WG (1980) Statistical methods, 6th edn. Iowa State University Press, Ames, IA

    Google Scholar 

  12. Le TD, Yamada SD, Rutgers JL, et al. (1999) Complete response of a stage IV uterine papillary serous carcinoma to neoadjuvant chemotherapy with taxol and carboplatin. Gynecol Oncol 73: 461–463

    Article  PubMed  CAS  Google Scholar 

  13. Compagnutta E, Giorda G, De Piero G, et al. (2004) Surgical treatment of recurrent endometrial carcinoma. Cancer 100:89–96

    Article  Google Scholar 

  14. Greven K, Olds W (1987) Radiotherapy in the management of endometrial carcinoma with cervical involvement. Cancer 60: 1737–1740

    Article  PubMed  CAS  Google Scholar 

  15. Grigsby PW, Pertz CA, Camel HM, et al. (1985) Stage II carcinoma of the endometrium: results of therapy and prognostic factors. Int J Radiat Oncol Biol Phys 11:1915–1923

    PubMed  CAS  Google Scholar 

  16. NCCN practice guidelines in oncology v.l.2005. Uterine cancers. http://www.nccn.org/professionals/physician

  17. Landgren RC, Fletcher GH, Delclos L, et al. (1976) Irradiation of endometrial cancer in patients with medical contraindication to surgery or with unresectable lesions. AJR Am J Roentgenol 126: 148–154

    PubMed  CAS  Google Scholar 

  18. Pliskow S, Penalver M, Averette HE (1990) Stage III and IV endometrial carcinoma: a review of 41 cases. Gynecol Oncol 38:210–215

    Article  PubMed  CAS  Google Scholar 

  19. Aalders JG, Aberler V, Kolstad P (1984) Stage IV endometrial carcinoma: a clinical and histological study of 83 patients. Gynecol Oncol 17:75–84

    Article  PubMed  CAS  Google Scholar 

  20. Behbakht K, Yorden EL, Casey C, et al. (1994) Prognosis indicators of survival in advanced endometrial cancer. Gynecol Oncol 55:363–367

    Article  PubMed  CAS  Google Scholar 

Download references

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Correspondence to Etsuko Miyagi.

Additional information

R. Numazaki and E. Miyagi contributed equally to this study.

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Numazaki, R., Miyagi, E., Konnai, K. et al. Analysis of stage IVB endometrial carcinoma patients with distant metastasis: a review of prognoses in 55 patients. Int J Clin Oncol 14, 344–350 (2009). https://doi.org/10.1007/s10147-009-0878-3

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  • DOI: https://doi.org/10.1007/s10147-009-0878-3

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