Salim Barquet-Muñoz, Antonio Bandala-Jaques, Ma Delia Perez-Montiel, Diddier Prada, Marithe Martínez-Flores, Rosa A Salcedo-Hernández, Carlos Pérez-Plasencia, Aaron Gonzalez-Enciso, David Cantu-de Leon
{"title":"接受根治性子宫切除术的子宫内膜癌患者宫旁受累的相关因素","authors":"Salim Barquet-Muñoz, Antonio Bandala-Jaques, Ma Delia Perez-Montiel, Diddier Prada, Marithe Martínez-Flores, Rosa A Salcedo-Hernández, Carlos Pérez-Plasencia, Aaron Gonzalez-Enciso, David Cantu-de Leon","doi":"10.1177/10668969231225773","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy.</p><p><strong>Methods: </strong>Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables.</p><p><strong>Results: </strong>We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; <i>P</i> = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; <i>P</i> = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; <i>P</i> < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; <i>P</i> = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; <i>P</i> = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; <i>P</i> = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread (<i>P</i> = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread (<i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated with Parametrial Involvement in Endometrial Carcinoma in Patients Treated with Radical Hysterectomy.\",\"authors\":\"Salim Barquet-Muñoz, Antonio Bandala-Jaques, Ma Delia Perez-Montiel, Diddier Prada, Marithe Martínez-Flores, Rosa A Salcedo-Hernández, Carlos Pérez-Plasencia, Aaron Gonzalez-Enciso, David Cantu-de Leon\",\"doi\":\"10.1177/10668969231225773\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy.</p><p><strong>Methods: </strong>Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables.</p><p><strong>Results: </strong>We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; <i>P</i> = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; <i>P</i> = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; <i>P</i> < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; <i>P</i> = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; <i>P</i> = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; <i>P</i> = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread (<i>P</i> = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread (<i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.</p>\",\"PeriodicalId\":14416,\"journal\":{\"name\":\"International Journal of Surgical Pathology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Surgical Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10668969231225773\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgical Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10668969231225773","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/22 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
简介:描述与宫旁受累相关的因素,以及这些因素如何改变接受根治性子宫切除术的子宫内膜癌患者的预后:描述与宫旁受累相关的因素,以及这些因素如何改变接受根治性子宫切除术的子宫内膜癌患者的预后:观察性研究:将患者分为宫旁受累和未受累两类。对宫旁扩散与临床、手术和病理变量之间的关系进行了描述性分析和比较分析:我们分析了85例患者,其中18例(21%)有宫旁受累。与宫旁受累相关的病理因素有:子宫内膜样亚型、3 级、预后不良的变异型(几率比(OR)3.41,95% CI 1.09-10.64;P = 0.035)、子宫肌层浸润超过 50%(OR 7.76,95% CI 1.65-36.44;P = 0.009)、浆膜受累(OR 17.07,95% CI 3.87-75.35;P P = 0.016)、腹膜细胞学阳性(OR 3.9,95% CI 1.04-14.77;P = 0.044)和淋巴结转移(OR 3.4;95% CI 1.16-9.97;P = 0.026)。无宫旁扩散组的五年无病生存率为74%(95% CI 57.4-85.4),有宫旁扩散组为50.8%(95% CI 22.7-73.4)(P = 0.001)。同样,无宫旁扩散组的5年总生存率为85.2%(95% CI 67.9-93.6),有宫旁扩散组为47.5%(95% CI 8.1-80.2)(P = 0.002):与宫旁受累相关的因素包括组织学预后不良、肿瘤影响子宫浆膜、宫颈或扩散至子宫以外。此外,宫旁受累会直接影响预后,降低总生存率和无病生存率,增加复发几率。
Factors Associated with Parametrial Involvement in Endometrial Carcinoma in Patients Treated with Radical Hysterectomy.
Introduction: Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy.
Methods: Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables.
Results: We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; P = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; P = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; P < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; P = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; P = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; P = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread (P = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread (P = 0.002).
Conclusion: Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.
期刊介绍:
International Journal of Surgical Pathology (IJSP) is a peer-reviewed journal published eight times a year, which offers original research and observations covering all major organ systems, timely reviews of new techniques and procedures, discussions of controversies in surgical pathology, case reports, and images in pathology. This journal is a member of the Committee on Publication Ethics (COPE).