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Çakır İ, Gülseren V, Özdemir İA, Abacı H, Talu ECK, Çakır ZE, Ata C, Kuru O, Gökçü M, Sancı M, Güngördük K. Characteristics of patients with late recurrence endometrial cancer. J Cancer Res Ther 2024; 20:232-237. [PMID: 38554326 DOI: 10.4103/jcrt.jcrt_888_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/18/2022] [Indexed: 04/01/2024]
Abstract
AIM We planned this study to assess endometrial cancer (EC) patients who had late metastasis. MATERIALS AND METHODS This retrospective study constituted a review of the records of patients who were diagnosed with EC and underwent hysterectomy at the Gynecologic Oncology Clinic between 1996 and 2018. Relapses occurring after the first three years following primary treatment of EC are considered late recurrences. Post-relapse survival (PRS) refers to the time to the last follow-up or the patient's death after relapse. RESULTS Late metastases were identified in 42 patients, 20 (47.6%) of whom had locoregional recurrence and 22 of whom (52.4%) had extrapelvic recurrence. Median disease-free survival (DFS) times were 61 (range: 43-78) and 65 (range: 48-81) months for the groups with locoregional and extrapelvic recurrences, respectively (P = 0.462). The 5-year PRS rate for the patients was 61.1%, with 63.8% having locoregional and 59.4% having extrapelvic late metastasis (P = 0.969). CONCLUSION Among the patients with late metastases, those with endometrioid type EC were found to have a better prognosis. It has been shown that locoregional or extrapelvic organ recurrence does not significantly affect survival in patients with late relapse. Although our results are not statistically significant for cases of locoregional late metastases, surgical resection increases survival rates.
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Affiliation(s)
- İlker Çakır
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Varol Gülseren
- Department of Obstetrics and Gynecology, Faculty of Medicine, Division of Gynecologic Oncology, Erciyes University, Kayseri, Turkey
| | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Sadi Konuk Education and Research Hospital, İstanbul, Turkey
| | - Hüseyin Abacı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | | | | | - Can Ata
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Oğuzhan Kuru
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Mehmet Gökçü
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Muzaffer Sancı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Kemal Güngördük
- Department of Obstetrics and Gynecology, Faculty of Medicine, Division of Gynecologic Oncology, Sıtkı Koçman University, Muğla, Turkey
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Gülseren V, Çakır İ, Kelten EC, Özcan A, Sancı M, Şen E, Çakır ZE, Özdemir İA, Güngördük K. Risk factors for omental metastasis and the effect of omentectomy on survival in type 2 endometrial cancer patients. Curr Probl Cancer 2023; 47:101018. [PMID: 37852848 DOI: 10.1016/j.currproblcancer.2023.101018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023]
Abstract
To investigate the risk factors for occult omental metastasis and the effect of omentectomy on the survival of type 2 endometrial cancer (EC) patients. This study enrolled patients who were diagnosed with high-risk (grade 3, serous, clear cell, undifferentiated, carcinosarcoma, or mixed type) EC between 2000 and 2021 and underwent surgery in our center. Data from 482 patients were analyzed retrospectively. Omentectomy was performed in 405 (84.0%) patients. Omental metastases were detected in 61 (12.7%) patients. Eighteen (29.5%) of these metastases were occult. Adnexal involvement, malignant cytology, and peritoneal spread were independent risk factors for omental metastasis. The 5-year overall survival (OS) rate was 59.5% in patients who underwent omentectomy and 64.7% in those who did not (P = 0.558). In patients with and without omental metastases, the overall 5-year OS rates were 34.9% and 63.5%, respectively (P < 0.001). The 5-year OS rates of patients with a normal omentum, gross tumors, and occult metastases were 63.5%, 26.9%, and 52.5%, respectively (P < 0.001). Omental metastases is not uncommon in type II endometrial cancer; approximately one third of patients have occult metastases. Factors - positive cytology, adnexal involvement, and peritoneal involvement are associated with higher probability of omental metastases.
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Affiliation(s)
- Varol Gülseren
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Erciyes University, Kayseri, Turkey.
| | - İlker Çakır
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Esra Canan Kelten
- Department of Medical Pathology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Aykut Özcan
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Muzaffer Sancı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Ertuğrul Şen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Erciyes University, Kayseri, Turkey
| | | | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Medipol University, Division of gynecologic oncology, İstanbul, Turkey
| | - Kemal Güngördük
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
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Çakır İ, Gülseren V, Aköz G, Şahin Z, Sever B, Çakır ZE, Sancı M, Kuru O, Özdemir İA, Güngördük K. The prognostic value of P53 index in predicting the recurrence of early low-risk endometrial cancer. J Obstet Gynaecol Res 2023; 49:2487-2493. [PMID: 37497887 DOI: 10.1111/jog.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
AIM We aimed to clarify the clinical value of P53 index in patients with early low-risk endometrial cancer (EC) and find an optimal cut-off value of P53 index for predicting the recurrence of these patients. METHODS The clinicopathological data of 157 patients with early low-risk EC (stage 1A with grade 1 or 2 endometrioid EC) were analyzed. The optimal cut-off value of the P53 index was calculated by the receiver operating characteristic curve analysis and Youden index. Cox regression model was used to evaluate the independent prognostic predictors of recurrence of EC. Then all patients were divided into two groups according to the optimal cut-off value of the P53 index. Differences of the clinicopathological parameters between the two groups were compared. RESULTS Multivariate analysis showed age PR (p = 0.020) and P53 (p = 0.001) were independent prognostic factors for the recurrence of EC. The value of P53 index was found to be the optimal cut-off point of 17.5% in estimating the recurrence of EC. The 5-year recurrence-free survival rates of patients in the low P53 index group (<17.5%) and the high P53 index group (≥17.5%) were 94.6% and 65.4% (p < 0.001). CONCLUSION It has been revealed that the P53 index is a prognostic factor for recurrence in early low-risk EC. The optimal cut-off value of P53 index may contribute to the postoperative individualized treatment options for early low-risk EC patients.
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Affiliation(s)
- İlker Çakır
- Department of Obstetrics and Gynecology, Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey
| | - Varol Gülseren
- Department of Obstetrics and Gynecology, Erciyes University, Kayseri, Turkey
| | - Gamze Aköz
- Department of Pathology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Zekiye Şahin
- Department of Obstetrics and Gynecology, Manisa City Hospital, Manisa, Turkey
| | - Barış Sever
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey
| | | | - Muzaffer Sancı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Oğuzhan Kuru
- Department of Obstetrics and Gynecology, İstanbul University-Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey
| | - Kemal Güngördük
- Department of Obstetrics and Gynecology, Muğla Sıtkı Koçman University, Muğla, Turkey
- Tepecik Education and Research Hospital, Izmir, Turkey
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Çakır İ, Gülseren V, Büyüktalancı E, Çakır ZE, Özer M, Ata C, Sancı M, Gökçü M, Erkılınç S, Güngördük K. The clinical significance of lymphovascular space invasion in patients with low-risk endometrial cancer. Rev Assoc Med Bras (1992) 2023; 69:e20221730. [PMID: 37466592 DOI: 10.1590/1806-9282.20221730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE The aim of this study was to assess the effect of lymphovascular space invasion on recurrence and disease-free survival in patients with low-risk endometrial cancer. METHODS The study included patients with stage 1A, grade 1-2 endometrioid endometrial cancer who underwent a total hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Independent prognostic predictors of endometrial cancer recurrence were assessed using the Cox regression model. Binary logistic regression analysis was used to identify the predictors of distant recurrence. Kaplan-Meier analysis was used to describe survival curves, and the log-rank test was used to compare the differences in survival curves. RESULTS A total of 189 patients met the inclusion criteria, of whom 24 (12.7%) had lymphovascular space invasion. The median follow-up time was 60 (3-137) months. Distant recurrence was present in 11 of 22 patients who developed recurrence. Kaplan-Meier survival analysis showed that the 5-year disease-free survival rates of patients with lymphovascular space invasion(+) and lymphovascular space invasion(-) were 62.5 and 91.9%, respectively, which were significantly lower (p<0.001). In multivariate Cox regression analysis, the presence of lymphovascular space invasion (p<0.001) and age ≥60 years (p=0.017) remained as prognostic factors for reduced disease-free survival. In binary logistic regression analysis, only lymphovascular space invasion (adjusted OR=13, 95%CI=1.456-116.092, p=0.022) was a prognostic factor for distant recurrence. CONCLUSION lymphovascular space invasion is a prognostic risk factor for recurrence and distant metastasis and also a predictor of poorer disease-free survival outcomes in low-risk endometrial cancer.
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Affiliation(s)
- İlker Çakır
- Buca Seyfi Demirsoy Education and Research Hospital, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Varol Gülseren
- Erciyes University, Department of Obstetrics and Gynecology - Kayseri, Turkey
| | - Emin Büyüktalancı
- Tepecik Education and Research Hospital, Department of Pathology - Izmir, Turkey
| | | | - Mehmet Özer
- Tepecik Education and Research Hospital, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Can Ata
- Buca Seyfi Demirsoy Education and Research Hospital, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Muzaffer Sancı
- Tepecik Education and Research Hospital, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Mehmet Gökçü
- İzmir University of Economics, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Selçuk Erkılınç
- Buca Seyfi Demirsoy Education and Research Hospital, Department of Obstetrics and Gynecology - Izmir, Turkey
| | - Kemal Güngördük
- Muğla Sıtkı Koçman University, Department of Obstetrics and Gynecology - Muğla, Turkey
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