PMID- 30286945
OWN - NLM
STAT- MEDLINE
DCOM- 20190123
LR  - 20190123
IS  - 1095-6859 (Electronic)
IS  - 0090-8258 (Linking)
VI  - 151
IP  - 3
DP  - 2018 Dec
TI  - Patterns of FIRST recurrence of stage IIIC1 endometrial cancer with no PARAAORTIC
      nodal assessment.
PG  - 395-400
LID - S0090-8258(18)31240-X [pii]
LID - 10.1016/j.ygyno.2018.09.021 [doi]
AB  - OBJECTIVE: To assess the rates and distribution of first recurrence in patients
      with FIGO stage IIIC1 endometrial cancer (EC) who did not undergo paraaortic
      dissection at surgical staging. METHODS: We retrospectively selected all (n=207) 
      stage IIIC1 patients treated at a single institution from 5/1993-1/2017. Sites of
      first recurrence were identified, disease-free (DFS) and overall survival (OS)
      calculated, multivariate logistic regression performed to identify factors
      associated with recurrence. RESULTS: Three-year DFS and OS were 66.5% and 85.7%, 
      respectively. The most common histology was endometroid (64.2%). Three-year DFS
      was 81% (SE+/-3.8%) endometrioid vs. 39.5% (SE+/-6.6%) non-endometrioid
      (P<0.001). Three-year OS was 96.9% (SE+/-1.8%) endometrioid vs. 65.6% (SE+/-6.7%)
      non-endometrioid (P<0.001). Sixty-two (30.1%) patients recurred. Patterns of
      recurrence were: 14 (8.3%) multiple sites, 17 (8.2%) abdominal, 14 (6.8%)
      extra-abdominal, 17 (8.3%) isolated nodal (8 of these (3.9%) paraaortic).
      Patients with isolated tumor cells (ITCs) in lymph nodes only had 12/71 (17%)
      recurrence rate vs. 50/135 (37%) for patients with micro-/macrometastasis. On
      univariate analysis, grade (HR 4.67 95%CI 1.5-14.5, P=0.008), histology (HR 4.9
      95%CI 2.6-9.3, P<0.001), myometrial invasion (HR 1.9 95%CI 1.04-3.5, P=0.04),
      pelvic washing (HR 2.2 95%CI 1.1-4.5, P=0.03), tumor volume in pelvic LNs (ITC
      vs. micro-/macrometastasis; HR 0.3 95%CI 0.2-0.7, P=0.003) were associated with
      recurrence. On multivariate analysis, only histology was associated with
      recurrence (HR 7.88 95%CI 3.43-18.13, P<0.001). CONCLUSIONS: Isolated paraaortic 
      recurrence in stage IIIC1 EC is uncommon. Micro-/macrometastasis were associated 
      with twice the recurrence rate compared to ITC. These data will help clinicians
      counsel patients with stage IIIC1 EC regarding paraaortic assessment.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Aloisi, Alessia
AU  - Aloisi A
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Casanova, Joao Miguel
AU  - Casanova JM
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Tseng, Jill H
AU  - Tseng JH
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Seader, Kristina A
AU  - Seader KA
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Nguyen, Nancy Thi
AU  - Nguyen NT
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Alektiar, Kaled M
AU  - Alektiar KM
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America;
      Weill Cornell Medical College, New York, NY, United States of America.
FAU - Makker, Vicky
AU  - Makker V
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America;
      Weill Cornell Medical College, New York, NY, United States of America.
FAU - Chiang, Sarah
AU  - Chiang S
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
FAU - Soslow, Robert A
AU  - Soslow RA
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America;
      Weill Cornell Medical College, New York, NY, United States of America.
FAU - Leitao, Mario M Jr
AU  - Leitao MM Jr
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America;
      Weill Cornell Medical College, New York, NY, United States of America.
FAU - Abu-Rustum, Nadeem R
AU  - Abu-Rustum NR
AD  - Memorial Sloan Kettering Cancer Center, New York, NY, United States of America;
      Weill Cornell Medical College, New York, NY, United States of America. Electronic
      address: abu-rusn@mskcc.org.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20181002
PL  - United States
TA  - Gynecol Oncol
JT  - Gynecologic oncology
JID - 0365304
SB  - IM
CIN - Gynecol Oncol. 2018 Dec;151(3):393-394. PMID: 30514490
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Endometrial Neoplasms/*pathology
MH  - Female
MH  - Humans
MH  - Lymph Nodes/*pathology
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*pathology
MH  - Neoplasm Staging
MH  - Retrospective Studies
PMC - PMC6281769
MID - NIHMS1508654
OTO - NOTNLM
OT  - *Endometrial cancer
OT  - *ITC
OT  - *Isolated tumor cells
OT  - *Recurrence
OT  - *Stage IIIC1
EDAT- 2018/10/06 06:00
MHDA- 2019/01/24 06:00
CRDT- 2018/10/06 06:00
PMCR- 2019/12/01 00:00
PHST- 2018/08/15 00:00 [received]
PHST- 2018/09/10 00:00 [revised]
PHST- 2018/09/19 00:00 [accepted]
PHST- 2019/12/01 00:00 [pmc-release]
PHST- 2018/10/06 06:00 [pubmed]
PHST- 2019/01/24 06:00 [medline]
PHST- 2018/10/06 06:00 [entrez]
AID - S0090-8258(18)31240-X [pii]
AID - 10.1016/j.ygyno.2018.09.021 [doi]
PST - ppublish
SO  - Gynecol Oncol. 2018 Dec;151(3):395-400. doi: 10.1016/j.ygyno.2018.09.021. Epub
      2018 Oct 2.