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Comparison of the prognostic significance of uterine factors and nodal status for endometrial cancer

  • Nicanor I. Barrena Medel
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY
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  • Thomas J. Herzog
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY

    Herbert Irving Comprehensive Cancer Center, New York, NY
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  • Israel Deutsch
    Affiliations
    Department of Radiation Oncology, Columbia University Collage of Physicians and Surgeons, New York, NY

    Herbert Irving Comprehensive Cancer Center, New York, NY
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  • William M. Burke
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY

    Herbert Irving Comprehensive Cancer Center, New York, NY
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  • Xuming Sun
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY
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  • Sharyn N. Lewin
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY

    Herbert Irving Comprehensive Cancer Center, New York, NY
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  • Jason D. Wright
    Correspondence
    Reprints: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave., 8th Floor, New York, NY 10032
    Affiliations
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, New York, NY

    Herbert Irving Comprehensive Cancer Center, New York, NY
    Search for articles by this author
Published:January 19, 2011DOI:https://doi.org/10.1016/j.ajog.2010.10.903

      Objective

      We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer.

      Study Design

      Women with stage I–IIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion ≥50%, cervical stromal involvement, and grade 3 histology.

      Results

      A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 63–72%) for group 1 (node positive/no RF) vs 69% (95% CI, 66–72%) for group 5 (node negative/multiple RF). Five–year survival was lower for node–positive patients with RF (58%; 95% CI, 54–61%) than node–positive patients without RF (68%; 95% CI, 63–72%).

      Conclusion

      Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis.

      Key words

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