Clinicopathological characteristics and possible risk factors for extrauterine metastases in endometrial carcinoma

Teuku Mirza Iskandar; Very Great Eka Putra; Ediwibowo Ambari; Endy Cahyono; Lubena

doi:10.15562/bmj.v11i3.3820

Clinicopathological characteristics and possible risk factors for extrauterine metastases in endometrial carcinoma

Teuku Mirza Iskandar ,

Very Great Eka Putra ,

Ediwibowo Ambari ,

Endy Cahyono ,

Lubena ,

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DOI: https://doi.org/10.15562/bmj.v11i3.3820 |
Published: 2022-10-13

Abstract

Introduction: Extrauterine metastases often occur in patients with advanced stages of endometrial carcinoma. Retroperitoneal lymph nodes and pelvic lymph nodes are the most common metastatic sites for endometrial carcinoma, while distant metastases, including those to the lung, liver, and brain, are uncommon. This study compares the characteristics of endometrial carcinoma with or without extrauterine metastases and evaluates risk factors associated with extrauterine metastases.

Methods: A retrospective analytical study of 155 women with a history of endometrial cancer

following complete surgical staging treatment from January 2017 to December 2021 at Dr. Kariadi General Hospital Semarang. All data were obtained using medical records. The clinical and pathological characteristics were compared using the Unpaired T-test and Chi-Square test. Multivariate logistic models were performed to estimate the odds ratio (OR) and 95% CI to analyze independent risk factors for extrauterine metastases.

Results A total of 155 endometrial cancer patients were included in this study. Of these, 77 patients have extrauterine metastases (49.67%). The most common site for extrauterine metastases is ovarian metastases (26.5%). Using univariable and bivariate analysis, tumor differentiation grading (OR=3.69, p=0.027) and myometrial invasion (OR=2.84, p=0.027) were the two risk factors associated with extrauterine metastases.

Conclusion: There were significant differences in clinicopathological characteristics between the two groups with and without extrauterine metastases. Tumor differentiation grading and myometrial invasion were two independent risk factors.

References

Zhang S, Gong TT, Liu FH, Jiang YT, Sun H, Ma XX, et al. Global, Regional, and National Burden of Endometrial Cancer, 1990-2017: Results From the Global Burden of Disease Study, 2017. Front Oncol. 2019;9:1440.
Mahdy H, Casey MJ, Crotzer D. Endometrial Cancer. StatPearls. 2022.
Zhao H, Yao Y, Yang H, Ma D, Chen A. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer. Medicine (Baltimore). 2017 Dec;96(51):e9223.
Casey L, Singh N. Metastases to the ovary arising from endometrial, cervical and fallopian tube cancer: recent advances. Histopathology. 2020 Jan 17;76(1):37–51.
Talhouk A, McAlpine JN. New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care. Gynecol Oncol Res Pract. 2016;3(1):1–12.
Ariyanto TB, Askandar B. Perbandingan Luaran Pasien Kanker Endometrium Yang Dilakukan Operasi Laparoskopi Dan Yang Dilakukan Operasi Laparotomi di RSUD Dr. Soetomo Tahun 2017. Med Heal Sci J. 2020;4(1):55–62.
Guo J, Cui X, Zhang X, Qian H, Duan H, Zhang Y. The Clinical Characteristics of Endometrial Cancer With Extraperitoneal Metastasis and the Value of Surgery in Treatment. Technol Cancer Res Treat. 19:1533033820945784.
Pellerin GP, Finan MA. Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol. 2005 Nov;193(5):1640–4.
Lee-may Chen JSB. Endometrial carcinoma: Epidemiology, risk factors, and prevention. https://www.uptodate.com/contents/endometrial-carcinoma-epidemiology-risk-factors-and-prevention?search=endometrial%20cancer&source=search_result&selectedTitle=10~150&usage_type=default&display_rank=10#H6. 2021.
Secord AA, Hasselblad V, Von Gruenigen VE, Gehrig PA, Modesitt SC, Bae-Jump V, et al. Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2016 Jan;140(1):184–90.
National Cancer Institute (NCI). PDQ Adult Treatment Editorial Board. Endometrial Cancer Treatment (PDQ®): Health Professional Version. 2022 Feb 24. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002. 2022.
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[1] Zhang S, Gong TT, Liu FH, Jiang YT, Sun H, Ma XX, et al. Global, Regional, and National Burden of Endometrial Cancer, 1990-2017: Results From the Global Burden of Disease Study, 2017. Front Oncol. 2019;9:1440.

[2] Mahdy H, Casey MJ, Crotzer D. Endometrial Cancer. StatPearls. 2022.

[3] Zhao H, Yao Y, Yang H, Ma D, Chen A. Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer. Medicine (Baltimore). 2017 Dec;96(51):e9223.

[4] Casey L, Singh N. Metastases to the ovary arising from endometrial, cervical and fallopian tube cancer: recent advances. Histopathology. 2020 Jan 17;76(1):37–51.

[5] Talhouk A, McAlpine JN. New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care. Gynecol Oncol Res Pract. 2016;3(1):1–12.

[6] Ariyanto TB, Askandar B. Perbandingan Luaran Pasien Kanker Endometrium Yang Dilakukan Operasi Laparoskopi Dan Yang Dilakukan Operasi Laparotomi di RSUD Dr. Soetomo Tahun 2017. Med Heal Sci J. 2020;4(1):55–62.

[7] Guo J, Cui X, Zhang X, Qian H, Duan H, Zhang Y. The Clinical Characteristics of Endometrial Cancer With Extraperitoneal Metastasis and the Value of Surgery in Treatment. Technol Cancer Res Treat. 19:1533033820945784.

[8] Pellerin GP, Finan MA. Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol. 2005 Nov;193(5):1640–4.

[9] Lee-may Chen JSB. Endometrial carcinoma: Epidemiology, risk factors, and prevention. https://www.uptodate.com/contents/endometrial-carcinoma-epidemiology-risk-factors-and-prevention?search=endometrial%20cancer&source=search_result&selectedTitle=10~150&usage_type=default&display_rank=10#H6. 2021.

[10] Secord AA, Hasselblad V, Von Gruenigen VE, Gehrig PA, Modesitt SC, Bae-Jump V, et al. Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol. 2016 Jan;140(1):184–90.

[11] National Cancer Institute (NCI). PDQ Adult Treatment Editorial Board. Endometrial Cancer Treatment (PDQ®): Health Professional Version. 2022 Feb 24. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002. 2022.

[12] Zhou F zhi, Chen Y nan, Zhang G nan. Ovarian metastasis in patient with endometrial carcinoma. Chinese J Cancer Res. 2005 Sep;17(3):230–4.

Clinicopathological characteristics and possible risk factors for extrauterine metastases in endometrial carcinoma

Abstract

References

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