Objective The purpose of this study was to explore in greater depth the outcomes of the Italian randomized trial investigating the role of pelvic lymphadenectomy in clinical early stage endometrial cancer. In the attempt to identify the patients with poorer prognosis, the impact of age and body mass index were also thoroughly investigated by cancer-specific survival (CSS) analyses. Study Design Survival outcomes of trial patients were analyzed in relation to age (>65 years and >65 years) in the 2 arms (lymphadenectomy and no lymphadenectomy) and in the whole population of the trial. Results Univariate and multivariable analyses of CSS and overall survival (OS) of patients showed that age >65 years is a strong independent poor prognostic factor (5-y OS 92.1% and 78.4% in >65 years and >65 years patients, respectively, P <.0001; 5-y CSS 93.8% and 83.5% in >65 years and >65 years patients, respectively, P =.003). Among women >65 years, node negative patients had 94.4% 5-y OS and 96.3% 5-y CSS vs 74.3% 5-y OS and 74.3% 5-y CSS for node positive patients (P =.009 and P =.002, respectively), while among women >65 y, node negative patients had 75.7% 5-y OS and 83.6% 5-y CSS vs 74.1% 5-y OS and 83.3% 5-y CSS for node positive patients (P =.55 and P =.58, respectively). Univariate and multivariable survival analyses in the whole trial population showed that older age, and higher tumor grade and stage were significantly associated to a worse prognosis. Conclusion Older women faced an intrinsic poorer survival whether or not they underwent lymphadenectomy, and, unexpectedly, irrespective of the presence of nodal metastasis. Only in older patients was obesity (body mass index >30) significantly associated with scarce prognosis

Benedetti Panici, P., Basile, S., Salerno, M., Di Donato, V., Marchetti, C., Perniola, G., et al. (2014). Secondary analyses from a randomized clinical trial: age as the key prognostic factor in endometrial carcinoma. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 210(4), 363e1-363e10 [10.1016/j.ajog.2013.12.025].

Secondary analyses from a randomized clinical trial: age as the key prognostic factor in endometrial carcinoma

LISSONI, ANDREA ALBERTO;
2014

Abstract

Objective The purpose of this study was to explore in greater depth the outcomes of the Italian randomized trial investigating the role of pelvic lymphadenectomy in clinical early stage endometrial cancer. In the attempt to identify the patients with poorer prognosis, the impact of age and body mass index were also thoroughly investigated by cancer-specific survival (CSS) analyses. Study Design Survival outcomes of trial patients were analyzed in relation to age (>65 years and >65 years) in the 2 arms (lymphadenectomy and no lymphadenectomy) and in the whole population of the trial. Results Univariate and multivariable analyses of CSS and overall survival (OS) of patients showed that age >65 years is a strong independent poor prognostic factor (5-y OS 92.1% and 78.4% in >65 years and >65 years patients, respectively, P <.0001; 5-y CSS 93.8% and 83.5% in >65 years and >65 years patients, respectively, P =.003). Among women >65 years, node negative patients had 94.4% 5-y OS and 96.3% 5-y CSS vs 74.3% 5-y OS and 74.3% 5-y CSS for node positive patients (P =.009 and P =.002, respectively), while among women >65 y, node negative patients had 75.7% 5-y OS and 83.6% 5-y CSS vs 74.1% 5-y OS and 83.3% 5-y CSS for node positive patients (P =.55 and P =.58, respectively). Univariate and multivariable survival analyses in the whole trial population showed that older age, and higher tumor grade and stage were significantly associated to a worse prognosis. Conclusion Older women faced an intrinsic poorer survival whether or not they underwent lymphadenectomy, and, unexpectedly, irrespective of the presence of nodal metastasis. Only in older patients was obesity (body mass index >30) significantly associated with scarce prognosis
Articolo in rivista - Articolo scientifico
Age Factors; Neoplasm Staging; Lymphatic Metastasis; Combined Modality Therapy; Humans; endometrial carcinoma; Prognosis; body mass index; Aged; prognostic factors; Body Mass Index; Multivariate Analysis; Carcinoma; Kaplan-Meier Estimate; Endometrial Neoplasms; age; Neoplasm Metastasis; Neoplasm Grading; Neoplasm Recurrence, Local; Lymph Node Excision; Female; Obesity, Abdominal
English
2014
210
4
363e1
363e10
reserved
Benedetti Panici, P., Basile, S., Salerno, M., Di Donato, V., Marchetti, C., Perniola, G., et al. (2014). Secondary analyses from a randomized clinical trial: age as the key prognostic factor in endometrial carcinoma. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 210(4), 363e1-363e10 [10.1016/j.ajog.2013.12.025].
File in questo prodotto:
File Dimensione Formato  
1 Secondary analysis.pdf

Solo gestori archivio

Dimensione 677.8 kB
Formato Adobe PDF
677.8 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/53042
Citazioni
  • Scopus 67
  • ???jsp.display-item.citation.isi??? 61
Social impact