Frontiers in Medicine (Apr 2022)
Risk Factors and Prognosis of Early Recurrence in Stage I–II Endometrial Cancer: A Large-Scale, Multi-Center, and Retrospective Study
- Yingyu Dou,
- Yingyu Dou,
- Kun Song,
- Yu Fu,
- Yu Fu,
- Yuanming Shen,
- Chuyao Zhang,
- Shuzhong Yao,
- Congjian Xu,
- Min Xia,
- Ge Lou,
- Jihong Liu,
- Bei Lin,
- Jianliu Wang,
- Weidong Zhao,
- Jieqing Zhang,
- Wenjun Cheng,
- Hongyan Guo,
- Ruixia Guo,
- Fengxia Xue,
- Xipeng Wang,
- Lili Han,
- Xia Zhao,
- Xiaomao Li,
- Ping Zhang,
- Jianguo Zhao,
- Jianguo Zhao,
- Jiezhi Ma,
- Wenting Li,
- Wenting Li,
- Xiaohang Yang,
- Xiaohang Yang,
- Zizhuo Wang,
- Zizhuo Wang,
- Jingbo Liu,
- Jingbo Liu,
- Yong Fang,
- Yong Fang,
- Kezhen Li,
- Kezhen Li,
- Gang Chen,
- Gang Chen,
- Chaoyang Sun,
- Chaoyang Sun,
- Xiaodong Cheng,
- Jie Jiang,
- Beibei Wang,
- Beibei Wang,
- Danfeng Luo,
- Danfeng Luo,
- Beihua Kong,
- The Chinese Endometrial Carcinoma Consortium (CECC)
Affiliations
- Yingyu Dou
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Yingyu Dou
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Kun Song
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Yu Fu
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Yu Fu
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yuanming Shen
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Chuyao Zhang
- Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- Shuzhong Yao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Congjian Xu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Min Xia
- Department of Gynecology and Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- Ge Lou
- Department of Gynecology Oncology, Harbin Medical University Cancer Hospital, Harbin, China
- Jihong Liu
- Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- Bei Lin
- 0Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, China
- Jianliu Wang
- 1Department of Gynecology, Peking University People's Hospital, Beijing, China
- Weidong Zhao
- 2Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Baohe District, China
- Jieqing Zhang
- 3Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, China
- Wenjun Cheng
- 4Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Hongyan Guo
- 5The Third Hospital of Peking University, Beijing, China
- Ruixia Guo
- 6Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Fengxia Xue
- 7Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
- Xipeng Wang
- 8Department of Gynecology and Obstetrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Lili Han
- 9Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
- Xia Zhao
- 0Department of Gynecology and Obstetrics, Development and Related Disease of Women and Children Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
- Xiaomao Li
- 1Department of Gynecology and Obstetrics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Ping Zhang
- 2Department of Gynecology, The Second Hospital of Shandong University, Jinan, China
- Jianguo Zhao
- 3Department of Gynecologic Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Affiliated Hospital of Nankai University, Tianjin, China
- Jianguo Zhao
- 4Department of Gynecologic Oncology, Tianjin Clinical Research Center for Gynecology and Obstetrics, Branch National Clinical Research Center for Gynecology and Obstetrics, Tianjin, China
- Jiezhi Ma
- 5Department of Obstetrics and Gynecology, Xiangya Third Hospital, Central South University, Changsha, China
- Wenting Li
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Wenting Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xiaohang Yang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Xiaohang Yang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Zizhuo Wang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Zizhuo Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Jingbo Liu
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Jingbo Liu
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yong Fang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Yong Fang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Kezhen Li
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Kezhen Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Gang Chen
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Gang Chen
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Chaoyang Sun
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Chaoyang Sun
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xiaodong Cheng
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Jie Jiang
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beibei Wang
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Beibei Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Danfeng Luo
- Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
- Danfeng Luo
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Beihua Kong
- Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- The Chinese Endometrial Carcinoma Consortium (CECC)
- DOI
- https://doi.org/10.3389/fmed.2022.808037
- Journal volume & issue
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Vol. 9
Abstract
ObjectiveThe aim of the present study was to determine overall survival (OS) and risk factors associated with early recurrence in patients with FIGO I–II stage endometrial carcinoma (EC).MethodsClinical features were retrospectively extracted from the database of China Endometrial Cancer Consortium from January 2000 to December 2019. A total of 2,974 patients with Federation International of Gynecology and Obstetrics (FIGO) I–II stage endometrial cancer were included. Kaplan-Meier survival analysis was used to assess OS and disease-specific survival. Cox proportional hazard model and Fine-Gray model were used to determine the factors related to OS. Binary logistic regression model was used to determine independent predictors of early relapse patients.ResultsOf these 2,974 ECs, 189 patients were confirmed to have relapse. The 5-year OS was significantly different between the recurrence and non-recurrence patients (p < 0.001). Three quarters of the relapse patients were reported in 36 months. The 5-year OS for early recurrence patients was shorter than late recurrence [relapse beyond 36 months, p < 0.001]. The grade 3 [odds ratio (OR) = 1.55, 95%CI 1.17–2.05, p = 0.002], lymphatic vascular infiltration (LVSI; OR = 3.36; 95%CI 1.50–7.54, p = 0.003), and myometrial infiltration (OR = 2.07, 95%CI 1.17—3.65, p = 0.012) were independent risk factors of early relapse. The protective factor of that is progesterone receptor (PR)-positive (OR = 0.50, 95%CI 0.27–0.92, p = 0.02). Bilateral ovariectomy could reduce recurrence risk rate (OR = 0.26, 95%CI 0.14–0.51, p < 0.001).ConclusionThe OS of early relapse EC is worse. Grade 3, LVSI, and myometrial infiltration are independent risk factors for early relapse EC. In addition, the protective factor is PR-positive for those people and bilateral salpingo-oophorectomy could reduce the risk of recurrence.
Keywords
