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    Analysis of prognostic factors in Grade 3 endometrioid type endometrial carcinoma
    (Wiley, 2022) Sahin, Eda Adeviye; Toprak, Serhat; Sayal, Hasan Berkan; Ekinci, Tekin; Yilmaz, Ercan; Bakay, Kadir; Melekoglu, Rauf
    Objective To investigate the prognostic factors of patients with Grade 3 endometrioid endometrial cancer (G3EEC). Methods This four-center, retrospective study included a total of 129 women with G3EEC. Demographic, clinicopathologic, and survival data were collected. Kaplan-Meier method was used for survival analysis. Predictors of outcome were analyzed using Cox proportional hazards models. Results Median age at the time of diagnosis was 63 (range 39-87) years and median follow up was 37 (range 6-126) months. For the entire cohort, the 5-year disease-free survival (DFS) and overall survival (OS) were 54.3% and 63.6%, respectively. The 5-year DFS rates for lymphovascular space invasion (LVSI) -positive and -negative patients were 41.6% and 88.3%, respectively (P < 0.001). The 5-year OS rates for LVSI-positive and -negative patients were 54.7% and 88.3%, respectively (P = 0.001). Positive LVSI status was identified as the independent prognostic factor for decreased DFS and OS (hazard ratio [HR] 5.5, 95% confidence interval [CI] 1.65-18.86; P = 0.006 versus HR 4.4, 95% CI 1.33-14.58; P = 0.013, respectively). Conclusion LVSI seems to be an independent prognostic factor for decreased DFS and OS in G3EEC patients.
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    Risk factors for cervical stromal involvement in endometrioid-type endometrial cancer
    (Wiley, 2021) Toprak, Serhat; Sahin, Eda Adeviye; Sahin, Hanifi; Tohma, Yusuf Aytac; Yilmaz, Ercan; Meydanli, Mehmet Mutlu
    ObjectiveThe aim of this study was to identify predictors of cervical stromal involvement in women with endometrioid-type endometrial cancer (EEC). MethodsA total of 795 patients with EEC who underwent comprehensive surgical staging including pelvic and para-aortic lymph node dissection between January 2007 and December 2018 were retrospectively analyzed. Data including age, menopausal status, serum CA-125 levels, tumor size, lymphovascular space invasion (LVSI), depth of myometrial invasion, positive peritoneal cytology, cervical stromal involvement, histologic grade, recurrence, and follow-up duration were recorded. ResultsMedian follow up was 49 months. Cervical stromal invasion was found in 88 patients. Multivariate analysis revealed that presence of LVSI (hazard ratio [HR] 2, 95% confidence interval [CI] 1.02-4.25, P = 0.045), a primary tumor diameter of at least 3 cm (HR 3, 95% CI 1.31-7.25, P = 0.010), and at least 50% deep myometrial invasion (HR 2.7, 95% CI 1.37-5.41, P = 0.004) were independent risk factors for cervical stromal involvement in patients with EEC. ConclusionOur study results suggest that presence of LVSI, a primary tumor diameter of at least 3 cm, and LVSI of at least 50% seem to be independent predictors of cervical involvement in women with EEC. Tumor diameter of >= 3 cm, and lymphovascular space invasion >= 50% seem to be independent predictors of cervical involvement in patients with endometrioid-type endometrial cancer.