2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer: Oncologic outcomes based on involvement of adnexa, serosa, or both Journal Article

   

Authors:	Rios-Doria, E.; Abu-Rustum, N. R.; Glaser, G.; McGree, M.; Eriksson, A. G.; Pham, M.; Soliman, P.; Ataseven, B.; Alektiar, K.; Zamarin, D.; Leitao, M. L. Jr; Mueller, J.
Article Title:	2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer: Oncologic outcomes based on involvement of adnexa, serosa, or both
Abstract:	Objective To assess clinicopathologic features and survival outcomes of patients with endometrial carcinoma involving adnexal, full-thickness serosal, or combined involvement. Methods This international, multi-institutional, retrospective study examined patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IIIA endometrial cancer and tumors involving the uterine serosa and/or adnexa, who were surgically staged between 2000 and 2019. Patients with sarcoma histology, concurrent endometrial/ovarian malignancy, neoadjuvant treatment, positive lymph nodes, or peritoneal disease were excluded. Results Of 185 patients identified, 139 had tumors with adnexal-only, 40 with serosal-only, and six with combined adnexal/serosal involvement. Median age at diagnosis was 60 years (range 23-89). Among tumors of endometrioid histology, 12 (48%) with serosal-only and 17 (19%) with adnexal-only involvement were FIGO grade 3 (p=0.007). Twenty-three tumors with serosal-only (64%) and 50 with adnexal-only (37%) involvement had lymphovascular invasion (p=0.004). Non-endometrioid histology was present in five tumors (83%) with combined adnexal/serosal, 15 (38%) with serosal-only, and 50 (36%) with adnexal-only involvement. Median follow-up was 77 months (range 0.6-254). Five-year progression-free survival and overall survival rates for all patients with stage IIIA disease were 73.8% (SE 3.5%) and 81.0% (SE 3.1%), respectively. For patients with adnexal-only, serosal-only, and combined adnexal/serosal involvement, 5-year progression-free survival rates were 80% (SE 3.8%), 61% (SE 8.3%), and 33% (SE 19.2%), respectively (p<0.01); 5-year overall survival rates were 85% (SE 3.3%), 70% (SE 7.8%), and 60% (SE 21.9%), respectively (p=0.09). On univariate analysis, tumors having serosal involvement with/without adnexal involvement, non-endometrioid histology, and lymphovascular invasion were significantly associated with progression. On multivariate analysis, tumors having serosal involvement with/without adnexal involvement remained significantly associated with recurrence (adjusted HR=2.2, 95% CI 1.2 to 4.3; p=0.01). Conclusions Patients with 2009 FIGO stage IIIA endometrial cancer have distinct survival outcomes depending upon adnexal and/or serosal involvement. Progression-free survival was worse for patients with serosal involvement after adjusting for histology, adjuvant treatment, and lymphovascular space invasion. © IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:	adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; clinical trial; mortality; cancer staging; endometrial neoplasms; neoplasm staging; pathology; retrospective study; multicenter study; endometrium tumor; therapy; uterine cancer; adnexa uteri; adnexal diseases; very elderly; humans; human; female; uterine adnexa
Journal Title:	International Journal of Gynecological Cancer
Volume:	34
Issue:	10
ISSN:	1048-891X
Publisher:	Lippincott Williams & Wilkins
Date Published:	2024-01-01
Start Page:	1580
End Page:	1587
Language:	English
DOI:	10.1136/ijgc-2024-005567
PUBMED:	39074930
PROVIDER:	scopus
PMCID:	PMC11458350
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85200392985&doi=10.1136%2fijgc-2024-005567&partnerID=40&md5=3955289e34142c2168835e74c73381ba
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Jennifer Mueller -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/220019