Analysis of prognostic risk factors of type Ⅰ endometrial cancer

doi:10.3760/cma.j.cn371439-20191112-00033

Abstract

Abstract:

Objective To study the risk factors affecting the prognosis of patients with type Ⅰ endometrial cancer. Methods A total of 279 patients with type Ⅰ endometrial cancer admitted to the First Affiliated Hospital of Southwest Medical University were enrolled from January 2010 to January 2015. The clinical data of all patients were retrospectively analyzed. The Kaplan-Meier method was used to estimate patients' survival rate. Cox regression risk model was used to analyze the risk factors that might affect the prognosis of patients with endometrial cancer. Results Of 279 patients with endometrial cancer, postoperative recurrence was observed in 36 patients. The 5-year disease free survival rate was 87.10%(243/279). The 2, 3 and 5-year survival rates were 95.9% (95%CI: 93.6%-98.3%), 94.3% (95%CI: 91.6%-97.2%), and 90.4% (95%CI: 86.6%-94.3%). Univariate analysis showed that obesity (HR=2.194, 95%CI: 1.031-4.671, P=0.041), myometrial invasion (HR=2.957, 95%CI: 1.382-6.329, P=0.005), tissue grading (G2: HR=3.271, 95%CI: 1.336-8.010, P=0.010; G3: HR=9.933, 95%CI: 3.565-27.672, P<0.001), tumor size (HR=8.067, 95%CI: 2.426-26.821, P=0.001), abdominal cytology (HR=3.293, 95%CI: 1.523-7.121, P=0.002), surgery-pathological staging (Ⅲ stage: HR=28.357, 95%CI: 11.516-69.828, P<0.001), nature of lymph node (HR=14.629, 95%CI: 5.023-42.606, P<0.001), cervical interstitial infiltration (HR=3.806, 95%CI: 1.653-8.764, P=0.002), accessory metastasis (HR=9.101, 95%CI: 3.831-21.622, P<0.001) and lymphovascular space invasion (HR=5.011, 95%CI: 2.233-11.249, P<0.001) were all correlated with the prognosis of the patients. Multivariate analysis showed that the independent risk factors for the prognosis of endometrial cancer patients were depth of myometrial invasion (HR=2.503, 95%CI: 1.115-5.616, P=0.026), histological grading (G2: HR=3.143, 95%CI: 1.205-8.198, P=0.019; G3: HR=3.655, 95%CI: 1.151-11.610, P=0.028), surgery-pathological staging (Ⅲ stage: HR=27.701, 95%CI: 9.608-79.869, P<0.001) and lymphovascular space invasion (HR=3.297, 95%CI: 1.370-7.936, P=0.008). Conclusion Obesity, myometrial invasion, tissue grading, tumor size, abdominal cytology, surgery-pathological staging, nature of lymph node, cervical interstitial infiltration, adnexal metastasis and lymphovascular space invasion all affect the prognosis of patients. Depth of myometrial invasion, histological grading, surgical-pathological staging and lymphovascular space invasion are independent risk factors for the prognosis of patients with Ⅰ endometrial cancer.

Key words: Endometrial neoplasms, Prognosis, Lymphovascular space invasion, Myometrial invasion

Zhou Luqiu, Liu Xianxi, Li Yan, Mao Xiguang. Analysis of prognostic risk factors of type Ⅰ endometrial cancer[J]. Journal of International Oncology, 2020, 47(6): 346-350.

Figures/Tables 4

References 16

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临床特征	例数(%)	临床特征	例数(%)
年龄(岁)		肥胖
<50	120(43.0)	是	89(31.9)
≥50	159(57.0)	否	190(68.1)
高血压		糖尿病
有	72(25.8)	有	76(27.2)
无	207(74.2)	无	203(72.8)
组织学分级		手术-病理分期
G1	166(59.5)	Ⅰ	218(78.1)
G2	88(31.5)	Ⅱ	23(8.2)
G3	25(9.0)	Ⅲ	38(13.6)
肿瘤大小(cm)		腹腔细胞学
≥2	151(54.1)	阳性	60(21.5)
<2	128(45.9)	阴性	219(78.5)
淋巴结切除		淋巴结性质^a
是	227(81.4)	阳性	11(4.8)
否	52(18.6)	阴性	216(95.2)
宫颈间质浸润		附件转移
是	36(12.9)	是	28(10.0)
否	243(87.1)	否	251(90.0)
淋巴血管间隙浸润		肌层浸润深度
是	32(11.5)	≥1/2	67(24.0)
否	247(88.5)	<1/2	212(76.0)

变量	HR值	95%CI	P值
年龄	2.096	0.916~4.796	0.080
高血压	1.797	0.822~3.936	0.142
肥胖	2.194	1.031~4.671	0.041
糖尿病	1.896	0.879~4.088	0.103
肌层浸润深度	2.957	1.382~6.329	0.005
组织学分级
G1	1	-	-
G2	3.271	1.336~8.010	0.010
G3	9.933	3.565~27.672	<0.001
肿瘤大小	8.067	2.426~26.821	0.001
腹腔细胞学	3.293	1.523~7.121	0.002
手术-病理分期
Ⅰ	1	-	-
Ⅱ	2.693	0.589~12.317	0.202
Ⅲ	28.357	11.516~69.828	<0.001
淋巴结切除	6.900	0.936~50.857	0.058
淋巴结性质^a	14.629	5.023~42.606	<0.001
宫颈间质浸润	3.806	1.653~8.764	0.002
附件转移	9.101	3.831~21.622	<0.001
淋巴血管间隙浸润	5.011	2.233~11.249	<0.001
术后辅助治疗	0.828	0.635~1.079	0.163
手术方式	1.142	0.844~1.545	0.389

变量	HR值	95%CI	P值
肥胖	0.510	0.216~1.206	0.125
肌层浸润深度	2.503	1.115~5.616	0.026
组织学分级(G1)	1	-	-
组织学分级(G2)	3.143	1.205~8.198	0.019
组织学分级(G3)	3.655	1.151~11.610	0.028
肿瘤大小	0.399	0.103~1.555	1.860
腹腔细胞学	1.298	0.510~3.306	0.584
手术-病理分期(Ⅰ期)	1	-	-
手术-病理分期(Ⅱ期)	1.368	0.277~6.755	0.701
手术-病理分期(Ⅲ期)	27.701	9.608~79.869	<0.001
淋巴结性质	1.169	0.292~4.677	0.825
宫颈间质浸润	1.436	0.335~26.709	0.626
附件转移	5.065	0.961~26.709	0.056
淋巴血管间隙浸润	3.297	1.370~7.936	0.008