Status of treatment for the overall population of patients with stage IVb endometrial cancer,and evaluation of the role of preoperative chemotherapy: A retrospective multi-institutional study of 426 patients in Japan |
| |
| Authors: | Takako Eto Toshiaki Saito Mototsugu Shimokawa Masayuki Hatae Nobuhiro Takeshima Hiroaki Kobayashi Takahiro Kasamatsu Hiroyuki Yoshikawa Toshiharu Kamura Ikuo Konishi |
| |
| Affiliation: | 1. Gynecology Service, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan;2. Cancer Biostatistics Laboratory, Clinical Research Institute, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan;3. Department of Obstetrics and Gynecology, Kagoshima City Hospital, 20-17 Kajiya-cho, Kagoshima 892-8580, Japan;4. Department of Gynecology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan;5. Department of Obstetrics and Gynecology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;6. Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;g Department of Obstetrics and Gynecology, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan;h Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahi machi, Kurume 830-0011, Japan;i Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan |
| |
| Abstract: | ObjectiveWe previously reported on the role of cytoreduction in 248 patients with surgical stage IVb endometrial cancer (EMCA). This study aimed to evaluate the clinical characteristics, prognosis according to initial treatment, and impact of preoperative chemotherapy in the overall population of patients with clinical and surgical stage IVb EMCA.MethodsA multi-institutional retrospective analysis was performed in 426 patients diagnosed with clinical and surgical stage IVb EMCA from 1996 to 2005. Factors associated with overall survival (OS) were identified using univariate and multivariate analyses.ResultsThe median OS for all 426 patients was 14 months. Patients were divided into three groups according to their initial treatment: primary surgery group (n = 279), primary chemotherapy group (n = 125), and palliative care group (n = 22). The median OS times for these groups were 21, 12, and 1 month, respectively (p < 0.0001). Patients in the primary surgery group had better performance status (PS) and lower numbers of extra-abdominal metastases than those in the primary chemotherapy group. Multivariate analysis identified good PS, endometrioid histology, absence of clinical intra-abdominal stage IVb metastasis, hysterectomy, and chemotherapy as independent predictors of OS. In the primary chemotherapy group, 59 patients subsequently underwent surgery, and these patients had similar OS to those in the primary surgery group.ConclusionsHysterectomy and chemotherapy may prolong OS in selected patients with stage IVb EMCA. Our data suggest that primary chemotherapy followed by surgery may be a useful treatment choice in patients not suitable for primary surgery. |
| |
| Keywords: | Stage IVb endometrial cancer Prognostic factor Extra-abdominal metastasis Hysterectomy Preoperative chemotherapy Neoadjuvant chemotherapy |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
