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Wang PH, Yang ST, Liu CH, Chang WH, Lee FK, Lee WL. Endometrial cancer: Part I. Basic concept. Taiwan J Obstet Gynecol 2022; 61:951-959. [DOI: 10.1016/j.tjog.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
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Chen JR, Chang TC, Fu HC, Lau HY, Chen IH, Ke YM, Liang YL, Chiang AJ, Huang CY, Chen YC, Hong MK, Wang YC, Huang KF, Hsiao SM, Wang PH. Outcomes of Patients With Surgically and Pathologically Staged IIIA-IVB Pure Endometrioid-type Endometrial Cancer: A Taiwanese Gynecology Oncology Group (TGOG-2005) Retrospective Cohort Study (A STROBE-Compliant Article). Medicine (Baltimore) 2016; 95:e3330. [PMID: 27082583 PMCID: PMC4839827 DOI: 10.1097/md.0000000000003330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n = 464; stage IV, n = 77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P = 0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P < 0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P < 0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P < 0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P < 0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P < 0.001, and HR 0.14, 95% CI 0.08-0.26; P < 0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P = 0.017, and HR 0.48; 95% CI 0.31-0.75; P = 0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality.
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Affiliation(s)
- Jen-Ruei Chen
- From the Department of Obstetrics and Gynecology, MacKay Memorial Hospital and MacKay Junior College of Medicine, Nursing and Management, Taipei (J-RC); Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan (T-CC); Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung (H-CF); Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei (H-YL, P-HW); Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu (I-HC), Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung (Y-MK), Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan (Y-LL); Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung (A-JC); Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei (C-YH); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (C-YH); Department of Obstetrics and Gynecology, Kaohsiung Medical University Chung-Ho Memorial Hospital and Kaohsiung Medical University, Kaohsiung (Y-CC), Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien (M-KH), Department of Obstetrics and Gynecology, Tri-Service General Hospital and National Defense Medical Center (Y-CW); Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan (K-FH); Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City (S-MH); Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei (H-YL, P-HW); and Department of Medical Research, China Medical University Hospital, Taichung (P-HW), Taiwan
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Lee FK, Yen MS, Wang PH. Is it safe to preserve the ovary of premenopausal women with supposed early-stage endometrial cancer? Taiwan J Obstet Gynecol 2016; 55:1-2. [DOI: 10.1016/j.tjog.2015.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2015] [Indexed: 12/16/2022] Open
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Lin LT, Tsui KH, Cheng JT, Yen MS, Li YT, Wang PH. Rapid presentation of endometrial carcinoma after removal of an intrauterine device. Taiwan J Obstet Gynecol 2014; 53:267-9. [DOI: 10.1016/j.tjog.2013.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 12/20/2022] Open
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Chen CH, Chang WH, Chiu LH, Chiu YH, Wang ID, Yen YK, Liu WM. Surgical advantages of laparoscopic pelvic and para-aortic lymph node dissection using the thermal welding instrument compared with conventional laparotomy for lymph node dissection. Gynecol Minim Invasive Ther 2013. [DOI: 10.1016/j.gmit.2013.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Lee WL, Lee FK, Su WH, Tsui KH, Kuo CD, Hsieh SLE, Wang PH. Hormone therapy for younger patients with endometrial cancer. Taiwan J Obstet Gynecol 2012; 51:495-505. [DOI: 10.1016/j.tjog.2012.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2012] [Indexed: 12/17/2022] Open
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