Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment

dc.contributor.authorBarlin, Joyce N.
dc.contributor.authorSoslow, Robert A.
dc.contributor.authorLutz, Megan
dc.contributor.authorZhou, Qin C.
dc.contributor.authorSt Clair, Caryn M.
dc.contributor.authorLeitao, Mario M.
dc.contributor.authorIasonos, Alexia
dc.contributor.authorHensley, Martee L.
dc.contributor.authorBarakat, Richard R.
dc.contributor.authorMatias-Guiu, Xavier
dc.contributor.authorAbu-Rustum, Nadeem R.
dc.date.accessioned2021-04-26T12:16:56Z
dc.date.available2021-04-26T12:16:56Z
dc.date.issued2013
dc.description.abstractObjective: We propose a new staging system for stage I endometrial cancer and compare its performance to the 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) systems. Methods: We analyzed patients with 1988 FIGO stage I endometrial cancer from January 1993 to August 2011. Low-grade carcinoma consisted of endometrioid grade 1 to grade 2 lesions. High-grade carcinoma consisted of endometrioid grade 3 or nonendometrioid carcinomas (serous, clear cell, and carcinosarcoma). The proposed system is as follows: IA. Low-grade carcinoma with less than half myometrial invasion. IA1 Negative nodes IA2 No nodes removed. IB. High-grade carcinoma with no myometrial invasion. IB1 Negative nodes. IB2 No nodes removed. IC. Low-grade carcinoma with half or greater myometrial invasion. IC1 Negative nodes. IC2 No nodes removed. ID. High-grade carcinoma with any myometrial invasion. ID1 Negative nodes. ID2 No nodes removed. Results: Data from 1843 patients were analyzed. When patients were restaged with our proposed system, the 5-year overall survival significantly differed (P < 0.001): IA1, 96.7%; IA2, 92.2%; IB1, 92.2%; IB2, 76.4%; IC1, 83.9%; IC2, 78.6%; ID1, 81.1%; and ID2, 68.8%. The bootstrap-corrected concordance probability estimate for the proposed system was 0.627 (95% confidence interval, 0.590-0.664) and was superior to the concordance probability estimate of 0.530 (95% confidence interval, 0.516-0.544) for the 2009 FIGO system. Conclusions: By incorporating histological subtype, grade, myometrial invasion, and whether lymph nodes were removed, our proposed system for stage I endometrial cancer has a superior predictive ability over the 2009 FIGO staging system and provides a novel binary grading system (low-grade including endometrioid grade 1-2 lesions; high-grade carcinoma consisting of endometrioid grade 3 carcinomas and nonendometrioid carcinomas).ca_ES
dc.description.sponsorshipThis work was supported in part by the National Institutes of Health Cancer Center core grant (P30 CA008748). The core grant provides funding to institutional cores, such as Biostatistics and Pathology, which were used in this study.ca_ES
dc.identifier.doihttps://doi.org/10.1097/IGC.0b013e3182a5055e
dc.identifier.idgrec021439
dc.identifier.issn1048-891X (paper)
dc.identifier.issn1525-1438 (electrònic)
dc.identifier.urihttp://hdl.handle.net/10459.1/71148
dc.language.isoengca_ES
dc.publisherBMJ Publishing Groupca_ES
dc.relation.isformatofVersió postprint del document publicat a: https://doi.org/10.1097/IGC.0b013e3182a5055eca_ES
dc.relation.ispartofInternational Journal of Gynecological Cancer, 2013, vol. 23, núm. 9, p. 1620–1628ca_ES
dc.rightscc-by-nc (c) Barlin et al., 2013ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectEndometrial cancerca_ES
dc.subjectStage Ica_ES
dc.subjectFIGOca_ES
dc.titleRedefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessmentca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/acceptedVersionca_ES
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