Frontiers in Medicine (Apr 2022)

Prognostic-Related Metabolic Score for Survival Prediction in Early-Stage Endometrioid Endometrial Cancer: A Multi-Center and Retrospective Study

  • Zizhuo Wang,
  • Zizhuo Wang,
  • Kun Song,
  • Jingbo Liu,
  • Jingbo Liu,
  • Qing Zhang,
  • Chuyao Zhang,
  • Beibei Wang,
  • Beibei Wang,
  • Yu Fu,
  • Yu Fu,
  • Yu Wang,
  • 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,
  • Jianguo Zhao,
  • Jiezhi Ma,
  • Qin Yao,
  • Wenting Li,
  • Wenting Li,
  • Xiaohang Yang,
  • Xiaohang Yang,
  • Yong Fang,
  • Yong Fang,
  • Gang Chen,
  • Gang Chen,
  • Kezhen Li,
  • Kezhen Li,
  • Yuanming Shen,
  • Chaoyang Sun,
  • Chaoyang Sun,
  • Beihua Kong

DOI
https://doi.org/10.3389/fmed.2022.830673
Journal volume & issue
Vol. 9

Abstract

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ObjectivePatients with endometrial cancer (EC) combined with metabolic syndrome (MetS) have a worse prognosis than those without MetS. This study aimed to investigate whether partial metabolic disorder significantly influenced early-stage endometrioid EC (EEC) survival and searched for a more efficient method to evaluate metabolic status.MethodsThis is a nationwide, multicenter cohort study that included 998 patients with primary early-stage EEC from 2001 to 2018. Patients were divided into different metabolic groups based on the diagnostic criteria of the Chinese Medical Association (CDC). The progression-free survival (PFS) time was compared between various metabolic status. Meanwhile, we established an EC Prognostic-Related Metabolic Score (ECPRM Score) to explore the association of the severity of metabolic status and early-stage EEC PFS. A nomogram was established for predicting PFS, which was externally validated in a testing set that includes 296 patients.ResultsA partial metabolic disorder, as well as MetS, was an independent risk factor of poor survival of patients with early-stage EEC [hazard ratio (HR) = 7.6, 95% CI = 1.01–57.5, p < 0.05]. A high ECPRM Score was associated with lower PFS (HR = 2.1, 95% CI = 1.05–4.0, p < 0.001). The nomogram, in which the ECPRM Score contributed most to the prognosis, exhibited excellent discrimination of survival supported by the internal and external validations. In addition, the calibration curve supports its robust predicting ability.ConclusionEven though they do not meet the criteria of MetS, partial metabolic disorders were also associated with adverse outcomes in early-stage EEC. The ECPRM Score is beneficial for clinicians to evaluate the severity of metabolic abnormalities and guide patients to ameliorate the poor prognosis of metabolic disorders.

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