A Proposal for a Classification for Recurrent Endometrial Cancer Analysis of a French Multicenter Database From the FRANCOGYN Study Group

被引：25

作者：

Bricou, Alexandre ^{[1
]}

Bendifallah, Sofiane ^{[2
]}

Daix-Moreux, Mathilde ^{[1
]}

Ouldamer, Lobna ^{[3
]}

Lavoue, Vincent ^{[4
]}

Benbara, Amelie ^{[1
]}

Huchon, Cyrille ^{[5
]}

Canlorbe, Geoffroy ^{[2
]}

Raimond, Emilie ^{[6
]}

Coutant, Charles ^{[7
]}

Graesslin, Olivier ^{[6
]}

Collinet, Pierre ^{[8
]}

Carcopino, Xavier ^{[9
]}

Touboul, Cyril ^{[10
,11
]}

Darai, Emile ^{[2
]}

Carbillon, Lionel ^{[1
]}

Ballester, Marcos ^{[2
]}

机构：

[1] Univ Paris 13, Jean Verdier Univ Hosp, AP HP, Dept Obstet & Gynecol, Ave 14 Juillet, F-93143 Bondy, France

[2] Univ Paris 06, Tenon Univ Hosp, AP HP, Dept Gynaecol & Obstet, Paris, France

[3] Univ Tours, Hop Bretonneau, CHR, Dept Obstet & Gynaecol, Tours, France

[4] Univ Rennes 1, CHU Rennes, Serv Gynecol, CRLCC Eugene Marquis, Rennes, France

[5] Ctr Hosp Intercommunal, Dept Gynaecol & Obstet, Poissy, France

[6] Champagne Univ Hosp, Inst Alix, Dept Obstet & Gynaecol, Reims, France

[7] Ctr Lutte Canc Georges Francois Leclerc, Dijon, France

[8] Ctr Hosp Reg Univ, Dept Obstet & Gynaecol, Lille, France

[9] Hop Nord Marseille, Dept Obstet & Gynaecol, Marseille, France

[10] Ctr Hosp Intercommunal, Dept Obstet & Gynecol, Creteil, France

[11] UPEC Paris XII, Fac Med Creteil, Paris, France

来源：

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER | 2018年 / 28卷 / 07期

关键词：

Endometrial cancer; Recurrences; Relapses; Classification; ESTRO CONSENSUS CONFERENCE; STAGE-I; RISK-FACTORS; FOLLOW-UP; CARCINOMA; SURVIVAL; PROGNOSIS; PATTERNS; ADENOCARCINOMA; THERAPY;

D O I：

10.1097/IGC.0000000000001296

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: Endometrial cancer (EC) recurrences are relatively common with no standardized way of describing them. We propose a new classification for them called locoregional, nodal, metastasis, carcinomatosis recurrences (rLMNC). Patients and Methods: The data of 1230 women with EC who were initially treated by primary surgery were included in this French multicenter retrospective study. Recurrences were classified based on dissemination pathways: (1) locoregional recurrence (rL); (2) nodal recurrence (rN) for lymphatic pathway; (3) distant organ recurrence (rM) for hematogenous pathway; and (4) carcinomatosis recurrence (rC) for peritoneal pathway. These pathways were further divided into subgroups. We compared recurrence free survival and overall survival (OS) between the 4 groups (rL/rN/rM/rC). Results: The median follow-up was 35.6 months (range, 1.70-167.60). One hundred ninety-eight women (18.2%) experienced a recurrence: 150 (75.8%) experienced a single-pathway recurrence and 48 (24.2%) a multiple-pathway recurrence. The 5-year OS was 34.1% (95% confidence interval [CI], 27.02%-43.1%), and the median time to first recurrence was 18.9 months (range, 0-152 months). The median survival after recurrence was 14.8 months (95% CI, 11.7-18.8). Among women with single pathway o f recurrence, a difference in 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) was found between the 4 rLNMC groups. The carcinomatosis group had the worst prognosis compared with other single recurrence pathways. Women with multiple recurrences had poorer 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) than those with single metastasis recurrence, other than women with peritoneal carcinomatosis. Conclusions: This easy-to-use and intuitive classification may be helpful to define EC recurrence risk groups and develop guidelines for the management of recurrence. Its prognosis value could also be a tool to select homogenous populations for further trials.

引用

页码：1278 / 1284

页数：7

共 30 条

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