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Evaluating the significance of location of lymph node metastasis and extranodal disease in women with stage IIIC endometrial cancer.
Garg, Gunjal; Morris, Robert T; Solomon, Leigh; Toy, Eugene P; Kruger, Michael; Clary, Karen; Munkarah, Adnan; Wright, Jason D.
Afiliação
  • Garg G; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA. gunjalgarg@yahoo.com
Gynecol Oncol ; 123(2): 208-13, 2011 Nov.
Article em En | MEDLINE | ID: mdl-21821278
ABSTRACT

OBJECTIVE:

To determine the prognostic significance of location of lymph node metastasis and extranodal disease for women with stage IIIC endometrial cancer.

METHODS:

Data were extracted from the Surveillance, Epidemiology, and End Results database between 1988 and 2005. Statistical analysis used Chi-square test, Kaplan-Meier method, and Cox proportional hazards model.

RESULTS:

A total of 2559 women were identified; 1453 stage IIIC1, and with 906 stage IIIC2 tumors. Compared to stage IIIC1; more stage IIIC2 patients demonstrated high-risk factors such as grade III disease (p<0.001), unfavorable histologic types (p=0.01), concurrent disease at other extrauterine sites (p<0.001), and greater than two positive lymph nodes (p<0.001). While the 5-year disease specific survival was comparable (p>0.05) among node positive patients found to have positive peritoneal cytology (44.0%), adnexal/serosal metastasis (42.9%), and vaginal/parametrial involvement (41.8%); it differed individually in all three categories from those with nodal metastasis alone (67.0%, p<0.001). Among women with extranodal disease, the location of nodal metastasis had no effect on survival (HR=0.92; 95% CI, 0.74-1.14). For women with node only stage IIIC tumors, those patients with positive para-aortic nodes were more likely to die from their tumors (HR=1.40; 95% CI, 1.12-1.75). CONCLUSION(S) Location of lymph node metastasis is prognostic in patients with nodal disease alone, and not in those with extranodal disease. Extranodal disease is associated with a poor prognosis and should be regarded in conjunction with location of lymph node metastasis for risk-stratification in stage IIIC endometrial cancer.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Endométrio Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Endométrio Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos