Stage IIIC endometrioid corpus cancer includes distinct subgroups

Andrea Mariani; Maurice J. Webb; Gary L. Keeney; Michael G. Haddock; Giacomo Aletti; Karl C. Podratz

doi:10.1006/gyno.2002.6789

Stage IIIC endometrioid corpus cancer includes distinct subgroups

Andrea Mariani, Maurice J. Webb, Gary L. Keeney, Michael G. Haddock, Giacomo Aletti, Karl C. Podratz

Research output: Contribution to journal › Article › peer-review

67 Scopus citations

Abstract

Objective. Because stage IIIC corpus cancer is a heterogeneous substage, the outcomes of patients with stage IIIC disease were assessed according to the extent of extrauterine disease. Methods. From 1984 through 1993, 51 patients with surgical stage IIIC corpus cancer were treated at our institution; 5 patients had tumors with nonendometrioid histologic features and were excluded from the analyses. Of the 46 patients with endometrioid carcinoma, 22 had lymph nodes as the only site of extrauterine disease (stage IIIC⁰) and 24 also had peritoneal cytologic, uterine serosal, adnexal, or vaginal involvement or a combination of these (stage IIIC^ab). The mean number of lymph nodes removed was 18 pelvic and 8 aortic nodes. Median follow-up for surviving patients was 84 months. Results. Patients with stage IIIC⁰ cancer had a 5-year cause-specific survival (CSS) of 72% and a 5-year recurrence-free survival (RFS) of 68%, and those with stage IIIC^ab had a CSS of 33% and an RFS of 25% (P < 0.01). Of the 22 patients with stage IIIC⁰ endometrioid cancer, 21 had adjuvant radiotherapy (1 also received chemotherapy) and 1 was not treated. Relapse occurred in 7 (32%) patients, with only 1 having an initial failure component outside the node-bearing areas (lung). Of the 24 patients with stage IIIC^ab cancer, 16 received adjuvant radiotherapy (1 had concomitant chemotherapy), 2 had chemotherapy, 4 had hormonal therapy, and 2 were not treated. We observed 16 recurrences (67%). Of the 14 patients with known initial sites of failure, 9 had an extranodal failure component. Conclusion. Assessment of CSS, RFS, and sites of relapse suggests that FIGO surgical stage IIIC endometrioid corpus cancer includes two distinct and readily separable subgroups: (1) stage IIIC⁰, nodal involvement only, and (2) stage IIIC^ab, nodal plus cytologic, uterine serosal, adnexal, or vaginal involvement, or a combination of these. Our results also suggest that different treatment strategies are needed for these subgroups.

Original language	English (US)
Pages (from-to)	112-117
Number of pages	6
Journal	Gynecologic oncology
Volume	87
Issue number	1
DOIs	https://doi.org/10.1006/gyno.2002.6789
State	Published - 2002

Keywords

Adjuvant therapy
Adnexal invasion
Endometrioid cancer
Extrauterine disease
Lymph nodes
Lymphatic metastases
Peritoneal cytology
Prognosis
Stage IIIC
Uterine serosal invasion
Vaginal invasion

ASJC Scopus subject areas

Oncology
Obstetrics and Gynecology

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10.1006/gyno.2002.6789

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@article{eda219015b0a4fef8aefd4d46fc8c8bb,

title = "Stage IIIC endometrioid corpus cancer includes distinct subgroups",

abstract = "Objective. Because stage IIIC corpus cancer is a heterogeneous substage, the outcomes of patients with stage IIIC disease were assessed according to the extent of extrauterine disease. Methods. From 1984 through 1993, 51 patients with surgical stage IIIC corpus cancer were treated at our institution; 5 patients had tumors with nonendometrioid histologic features and were excluded from the analyses. Of the 46 patients with endometrioid carcinoma, 22 had lymph nodes as the only site of extrauterine disease (stage IIIC0) and 24 also had peritoneal cytologic, uterine serosal, adnexal, or vaginal involvement or a combination of these (stage IIICab). The mean number of lymph nodes removed was 18 pelvic and 8 aortic nodes. Median follow-up for surviving patients was 84 months. Results. Patients with stage IIIC0 cancer had a 5-year cause-specific survival (CSS) of 72% and a 5-year recurrence-free survival (RFS) of 68%, and those with stage IIICab had a CSS of 33% and an RFS of 25% (P < 0.01). Of the 22 patients with stage IIIC0 endometrioid cancer, 21 had adjuvant radiotherapy (1 also received chemotherapy) and 1 was not treated. Relapse occurred in 7 (32%) patients, with only 1 having an initial failure component outside the node-bearing areas (lung). Of the 24 patients with stage IIICab cancer, 16 received adjuvant radiotherapy (1 had concomitant chemotherapy), 2 had chemotherapy, 4 had hormonal therapy, and 2 were not treated. We observed 16 recurrences (67%). Of the 14 patients with known initial sites of failure, 9 had an extranodal failure component. Conclusion. Assessment of CSS, RFS, and sites of relapse suggests that FIGO surgical stage IIIC endometrioid corpus cancer includes two distinct and readily separable subgroups: (1) stage IIIC0, nodal involvement only, and (2) stage IIICab, nodal plus cytologic, uterine serosal, adnexal, or vaginal involvement, or a combination of these. Our results also suggest that different treatment strategies are needed for these subgroups.",

keywords = "Adjuvant therapy, Adnexal invasion, Endometrioid cancer, Extrauterine disease, Lymph nodes, Lymphatic metastases, Peritoneal cytology, Prognosis, Stage IIIC, Uterine serosal invasion, Vaginal invasion",

author = "Andrea Mariani and Webb, {Maurice J.} and Keeney, {Gary L.} and Haddock, {Michael G.} and Giacomo Aletti and Podratz, {Karl C.}",

year = "2002",

doi = "10.1006/gyno.2002.6789",

language = "English (US)",

volume = "87",

pages = "112--117",

journal = "Gynecologic oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

number = "1",

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T1 - Stage IIIC endometrioid corpus cancer includes distinct subgroups

AU - Mariani, Andrea

AU - Webb, Maurice J.

AU - Keeney, Gary L.

AU - Haddock, Michael G.

AU - Aletti, Giacomo

AU - Podratz, Karl C.

PY - 2002

Y1 - 2002

N2 - Objective. Because stage IIIC corpus cancer is a heterogeneous substage, the outcomes of patients with stage IIIC disease were assessed according to the extent of extrauterine disease. Methods. From 1984 through 1993, 51 patients with surgical stage IIIC corpus cancer were treated at our institution; 5 patients had tumors with nonendometrioid histologic features and were excluded from the analyses. Of the 46 patients with endometrioid carcinoma, 22 had lymph nodes as the only site of extrauterine disease (stage IIIC0) and 24 also had peritoneal cytologic, uterine serosal, adnexal, or vaginal involvement or a combination of these (stage IIICab). The mean number of lymph nodes removed was 18 pelvic and 8 aortic nodes. Median follow-up for surviving patients was 84 months. Results. Patients with stage IIIC0 cancer had a 5-year cause-specific survival (CSS) of 72% and a 5-year recurrence-free survival (RFS) of 68%, and those with stage IIICab had a CSS of 33% and an RFS of 25% (P < 0.01). Of the 22 patients with stage IIIC0 endometrioid cancer, 21 had adjuvant radiotherapy (1 also received chemotherapy) and 1 was not treated. Relapse occurred in 7 (32%) patients, with only 1 having an initial failure component outside the node-bearing areas (lung). Of the 24 patients with stage IIICab cancer, 16 received adjuvant radiotherapy (1 had concomitant chemotherapy), 2 had chemotherapy, 4 had hormonal therapy, and 2 were not treated. We observed 16 recurrences (67%). Of the 14 patients with known initial sites of failure, 9 had an extranodal failure component. Conclusion. Assessment of CSS, RFS, and sites of relapse suggests that FIGO surgical stage IIIC endometrioid corpus cancer includes two distinct and readily separable subgroups: (1) stage IIIC0, nodal involvement only, and (2) stage IIICab, nodal plus cytologic, uterine serosal, adnexal, or vaginal involvement, or a combination of these. Our results also suggest that different treatment strategies are needed for these subgroups.

AB - Objective. Because stage IIIC corpus cancer is a heterogeneous substage, the outcomes of patients with stage IIIC disease were assessed according to the extent of extrauterine disease. Methods. From 1984 through 1993, 51 patients with surgical stage IIIC corpus cancer were treated at our institution; 5 patients had tumors with nonendometrioid histologic features and were excluded from the analyses. Of the 46 patients with endometrioid carcinoma, 22 had lymph nodes as the only site of extrauterine disease (stage IIIC0) and 24 also had peritoneal cytologic, uterine serosal, adnexal, or vaginal involvement or a combination of these (stage IIICab). The mean number of lymph nodes removed was 18 pelvic and 8 aortic nodes. Median follow-up for surviving patients was 84 months. Results. Patients with stage IIIC0 cancer had a 5-year cause-specific survival (CSS) of 72% and a 5-year recurrence-free survival (RFS) of 68%, and those with stage IIICab had a CSS of 33% and an RFS of 25% (P < 0.01). Of the 22 patients with stage IIIC0 endometrioid cancer, 21 had adjuvant radiotherapy (1 also received chemotherapy) and 1 was not treated. Relapse occurred in 7 (32%) patients, with only 1 having an initial failure component outside the node-bearing areas (lung). Of the 24 patients with stage IIICab cancer, 16 received adjuvant radiotherapy (1 had concomitant chemotherapy), 2 had chemotherapy, 4 had hormonal therapy, and 2 were not treated. We observed 16 recurrences (67%). Of the 14 patients with known initial sites of failure, 9 had an extranodal failure component. Conclusion. Assessment of CSS, RFS, and sites of relapse suggests that FIGO surgical stage IIIC endometrioid corpus cancer includes two distinct and readily separable subgroups: (1) stage IIIC0, nodal involvement only, and (2) stage IIICab, nodal plus cytologic, uterine serosal, adnexal, or vaginal involvement, or a combination of these. Our results also suggest that different treatment strategies are needed for these subgroups.

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KW - Extrauterine disease

KW - Lymph nodes

KW - Lymphatic metastases

KW - Peritoneal cytology

KW - Prognosis

KW - Stage IIIC

KW - Uterine serosal invasion

KW - Vaginal invasion

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JO - Gynecologic oncology

JF - Gynecologic oncology

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Stage IIIC endometrioid corpus cancer includes distinct subgroups

Abstract

Keywords

ASJC Scopus subject areas

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