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Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study.

Publication ,  Journal Article
Felix, AS; Sinnott, JA; Cohn, DE; Duggan, MA; Havrilesky, LJ; Olawaiye, AB; Mariani, A; Rodriquez, M; Brett, MA; Dinoi, G; Meade, CE; Hall, B ...
Published in: Gynecol Oncol
November 2023

OBJECTIVE: Endometrial cancer stage is a strong prognostic factor; however, the current stage classification does not incorporate transtubal spread as determined by intraluminal tumor cells (ILTCs). We examined relationships between ILTCs and survival outcomes according to histological subtype and stage and examined whether identification of ILTCs improves prognostic accuracy of endometrial cancer staging. METHODS: We conducted a retrospective cohort study of women diagnosed with endometrial cancer at five academic hospitals between 2007 and 2012. Pathologists determined ILTC presence (no vs. yes) and location (free in lumen vs. attached to epithelial surface) based on pathology review of hematoxylin and eosin-stained sections of fallopian tubes. Associations between ILTCs with time to recurrence (TTR) and overall survival (OS) were examined with Cox proportional hazards models adjusted for other prognostic factors. Model discrimination metrics were used to assess the addition of ILTCs to stage for prediction of 5-year TTR and OS. RESULTS: In the overall study population (N = 1303), ILTCs were not independently associated with TTR (HR = 0.95, 95% CI = 0.69-1.32) or OS (HR = 0.97, 95% CI = 0.72-1.31). Among 805 women with stage I disease, ILTCs were independently associated with worse TTR (HR = 2.31, 95% CI = 1.06-5.05) and OS (HR = 2.16, 95% CI = 1.14-4.11). Upstaging early-stage cases with ILTCs present did not increase model discrimination. CONCLUSION: While our data do not suggest that endometrial cancer staging guidelines should be revised to include ILTCs, associations between ILTCs and reduced survival observed among stage I cases suggest this tumor feature holds clinical relevance for subgroups of endometrial cancer patients.

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

November 2023

Volume

178

Start / End Page

130 / 137

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Humans
  • Female
  • Fallopian Tubes
  • Endometrial Neoplasms
  • 3215 Reproductive medicine
  • 3211 Oncology and carcinogenesis
 

Citation

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Felix, A. S., Sinnott, J. A., Cohn, D. E., Duggan, M. A., Havrilesky, L. J., Olawaiye, A. B., … Suarez, A. A. (2023). Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study. Gynecol Oncol, 178, 130–137. https://doi.org/10.1016/j.ygyno.2023.10.004
Felix, Ashley S., Jennifer A. Sinnott, David E. Cohn, Máire A. Duggan, Laura J. Havrilesky, Alexander B. Olawaiye, Andrea Mariani, et al. “Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study.Gynecol Oncol 178 (November 2023): 130–37. https://doi.org/10.1016/j.ygyno.2023.10.004.
Felix AS, Sinnott JA, Cohn DE, Duggan MA, Havrilesky LJ, Olawaiye AB, et al. Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study. Gynecol Oncol. 2023 Nov;178:130–7.
Felix, Ashley S., et al. “Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study.Gynecol Oncol, vol. 178, Nov. 2023, pp. 130–37. Pubmed, doi:10.1016/j.ygyno.2023.10.004.
Felix AS, Sinnott JA, Cohn DE, Duggan MA, Havrilesky LJ, Olawaiye AB, Mariani A, Rodriquez M, Brett MA, Dinoi G, Meade CE, Hall B, Goldfeld E, Elishaev E, Sherman ME, Suarez AA. Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study. Gynecol Oncol. 2023 Nov;178:130–137.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

November 2023

Volume

178

Start / End Page

130 / 137

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Humans
  • Female
  • Fallopian Tubes
  • Endometrial Neoplasms
  • 3215 Reproductive medicine
  • 3211 Oncology and carcinogenesis