Lymph node status did not significantly improve the predictability of survival in patients with clinically early-stage endometrial cancer

HYo Sook Bae, Jong Min Lee, Jae Kwan Lee, Jae Weon Kim, Chi Heum Cho, Seok Mo Kim, Sang Yoon Park, Chan Yong Park, Ki Tae Kim, Sokbom Kang

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer. Methods: The records of 661 patients with apparently uterine-confined disease were reviewed. The performance in predicting overall survival and cause-specific survival was compared between a multivariate prognostic model with nodal status and a model without nodal status by calculating Harrell concordance index. Results: Among 661 patients with clinically early-stage endometrial cancer, the lymph node metastasis rate was 8.3% (55/661). Lymph node metastasis independently associated with cause-specific survival only when no stratification according to adjuvant treatment was applied (P = 0.035). After stratification according to adjuvant radiotherapy, lymph node status marginally associated with cause-specific survival (P = 0.073), whereas myometrial invasion retained its strong association with cause-specific survival (P < 0.001). However, there was no significant difference in the performance of the survival model using only uterine factors and the model using lymph node status and uterine factors (concordance index, 0.77 vs 0.77, respectively; P = 0.798). Conclusions: Knowledge of lymph node status did not significantly improve the performance of survival prediction in apparently uterine-confined endometrial cancer, although it was independently associated with survival. In the patients with clinically early-stage endometrial cancer, the accuracy of the prediction of survival was comparable between risk grouping without lymph node status and that including lymph node status.

Original languageEnglish
Pages (from-to)1449-1454
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number8
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Endometrial Neoplasms
Lymph Nodes
Survival
Uterine Diseases
Neoplasm Metastasis
Adjuvant Radiotherapy

Keywords

  • Endometrial cancer
  • Lymph node metastasis
  • Risk factor
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Lymph node status did not significantly improve the predictability of survival in patients with clinically early-stage endometrial cancer. / Bae, HYo Sook; Lee, Jong Min; Lee, Jae Kwan; Kim, Jae Weon; Cho, Chi Heum; Kim, Seok Mo; Park, Sang Yoon; Park, Chan Yong; Kim, Ki Tae; Kang, Sokbom.

In: International Journal of Gynecological Cancer, Vol. 24, No. 8, 01.01.2014, p. 1449-1454.

Research output: Contribution to journalArticle

Bae, HYo Sook ; Lee, Jong Min ; Lee, Jae Kwan ; Kim, Jae Weon ; Cho, Chi Heum ; Kim, Seok Mo ; Park, Sang Yoon ; Park, Chan Yong ; Kim, Ki Tae ; Kang, Sokbom. / Lymph node status did not significantly improve the predictability of survival in patients with clinically early-stage endometrial cancer. In: International Journal of Gynecological Cancer. 2014 ; Vol. 24, No. 8. pp. 1449-1454.
@article{9aa4a4a6952e4201b009fac9f30299e8,
title = "Lymph node status did not significantly improve the predictability of survival in patients with clinically early-stage endometrial cancer",
abstract = "Objective: The aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer. Methods: The records of 661 patients with apparently uterine-confined disease were reviewed. The performance in predicting overall survival and cause-specific survival was compared between a multivariate prognostic model with nodal status and a model without nodal status by calculating Harrell concordance index. Results: Among 661 patients with clinically early-stage endometrial cancer, the lymph node metastasis rate was 8.3{\%} (55/661). Lymph node metastasis independently associated with cause-specific survival only when no stratification according to adjuvant treatment was applied (P = 0.035). After stratification according to adjuvant radiotherapy, lymph node status marginally associated with cause-specific survival (P = 0.073), whereas myometrial invasion retained its strong association with cause-specific survival (P < 0.001). However, there was no significant difference in the performance of the survival model using only uterine factors and the model using lymph node status and uterine factors (concordance index, 0.77 vs 0.77, respectively; P = 0.798). Conclusions: Knowledge of lymph node status did not significantly improve the performance of survival prediction in apparently uterine-confined endometrial cancer, although it was independently associated with survival. In the patients with clinically early-stage endometrial cancer, the accuracy of the prediction of survival was comparable between risk grouping without lymph node status and that including lymph node status.",
keywords = "Endometrial cancer, Lymph node metastasis, Risk factor, Survival",
author = "Bae, {HYo Sook} and Lee, {Jong Min} and Lee, {Jae Kwan} and Kim, {Jae Weon} and Cho, {Chi Heum} and Kim, {Seok Mo} and Park, {Sang Yoon} and Park, {Chan Yong} and Kim, {Ki Tae} and Sokbom Kang",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/IGC.0000000000000237",
language = "English",
volume = "24",
pages = "1449--1454",
journal = "International journal of gynecological cancer : official journal of the International Gynecological Cancer Society",
issn = "1048-891X",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Lymph node status did not significantly improve the predictability of survival in patients with clinically early-stage endometrial cancer

AU - Bae, HYo Sook

AU - Lee, Jong Min

AU - Lee, Jae Kwan

AU - Kim, Jae Weon

AU - Cho, Chi Heum

AU - Kim, Seok Mo

AU - Park, Sang Yoon

AU - Park, Chan Yong

AU - Kim, Ki Tae

AU - Kang, Sokbom

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: The aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer. Methods: The records of 661 patients with apparently uterine-confined disease were reviewed. The performance in predicting overall survival and cause-specific survival was compared between a multivariate prognostic model with nodal status and a model without nodal status by calculating Harrell concordance index. Results: Among 661 patients with clinically early-stage endometrial cancer, the lymph node metastasis rate was 8.3% (55/661). Lymph node metastasis independently associated with cause-specific survival only when no stratification according to adjuvant treatment was applied (P = 0.035). After stratification according to adjuvant radiotherapy, lymph node status marginally associated with cause-specific survival (P = 0.073), whereas myometrial invasion retained its strong association with cause-specific survival (P < 0.001). However, there was no significant difference in the performance of the survival model using only uterine factors and the model using lymph node status and uterine factors (concordance index, 0.77 vs 0.77, respectively; P = 0.798). Conclusions: Knowledge of lymph node status did not significantly improve the performance of survival prediction in apparently uterine-confined endometrial cancer, although it was independently associated with survival. In the patients with clinically early-stage endometrial cancer, the accuracy of the prediction of survival was comparable between risk grouping without lymph node status and that including lymph node status.

AB - Objective: The aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer. Methods: The records of 661 patients with apparently uterine-confined disease were reviewed. The performance in predicting overall survival and cause-specific survival was compared between a multivariate prognostic model with nodal status and a model without nodal status by calculating Harrell concordance index. Results: Among 661 patients with clinically early-stage endometrial cancer, the lymph node metastasis rate was 8.3% (55/661). Lymph node metastasis independently associated with cause-specific survival only when no stratification according to adjuvant treatment was applied (P = 0.035). After stratification according to adjuvant radiotherapy, lymph node status marginally associated with cause-specific survival (P = 0.073), whereas myometrial invasion retained its strong association with cause-specific survival (P < 0.001). However, there was no significant difference in the performance of the survival model using only uterine factors and the model using lymph node status and uterine factors (concordance index, 0.77 vs 0.77, respectively; P = 0.798). Conclusions: Knowledge of lymph node status did not significantly improve the performance of survival prediction in apparently uterine-confined endometrial cancer, although it was independently associated with survival. In the patients with clinically early-stage endometrial cancer, the accuracy of the prediction of survival was comparable between risk grouping without lymph node status and that including lymph node status.

KW - Endometrial cancer

KW - Lymph node metastasis

KW - Risk factor

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=84925685064&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925685064&partnerID=8YFLogxK

U2 - 10.1097/IGC.0000000000000237

DO - 10.1097/IGC.0000000000000237

M3 - Article

C2 - 25180462

AN - SCOPUS:84925685064

VL - 24

SP - 1449

EP - 1454

JO - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

JF - International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

SN - 1048-891X

IS - 8

ER -