Abstract：
OBJECTIVE: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC.
METHODS: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files.
RESULTS: The median age of the patients was 60 years (range 31-89). The median follow-up time of the patients was 63.6 months (range 3.3-185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients.
CONCLUSIONS: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.
METHODS: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files.
RESULTS: The median age of the patients was 60 years (range 31-89). The median follow-up time of the patients was 63.6 months (range 3.3-185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients.
CONCLUSIONS: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.
摘要：
目的：子宫内膜样癌（EEC）是子宫内膜癌（EC）中最常见的亚型。我们的研究旨在探讨影响1A和1B期EEC患者复发的因素。
方法：我们的研究包括2010年至2018年在我们中心诊断为国际妇产科联合会1A/1BEEC期的284例患者。回顾性地从他们的电子文件中获得了患者的临床病理特征。
结果：患者的中位年龄为60岁（范围31-89岁）。患者的中位随访时间为63.6个月（范围3.3-185.6）。22例（7.74%）患者在随访期间复发。在复发患者中，59.1%处于1AECC阶段，40.9%处于1B阶段。在我们的研究中,Theone-,三-，5年无复发生存率（RFS）为98.9%，95.4%,和92.9%，分别。在多变量分析中，发现分级和肿瘤大小是所有1期EEC患者RFS的独立参数.此外，发现Ki-67指数影响1A期EEC患者的RFS，肿瘤分级影响1B期EEC患者的RFS。在与时间相关的接收器工作特性曲线分析中，在1期EEC患者中,确定了肿瘤大小和Ki-67指数的统计学显著临界值.
结论：就肿瘤大小而言，高风险组的1期-EEC患者，应密切监测Ki-67和级别是否复发。定义1期EEC患者复发的预后因素可能会导致随访算法的变化。
方法：我们的研究包括2010年至2018年在我们中心诊断为国际妇产科联合会1A/1BEEC期的284例患者。回顾性地从他们的电子文件中获得了患者的临床病理特征。
结果：患者的中位年龄为60岁（范围31-89岁）。患者的中位随访时间为63.6个月（范围3.3-185.6）。22例（7.74%）患者在随访期间复发。在复发患者中，59.1%处于1AECC阶段，40.9%处于1B阶段。在我们的研究中,Theone-,三-，5年无复发生存率（RFS）为98.9%，95.4%,和92.9%，分别。在多变量分析中，发现分级和肿瘤大小是所有1期EEC患者RFS的独立参数.此外，发现Ki-67指数影响1A期EEC患者的RFS，肿瘤分级影响1B期EEC患者的RFS。在与时间相关的接收器工作特性曲线分析中，在1期EEC患者中,确定了肿瘤大小和Ki-67指数的统计学显著临界值.
结论：就肿瘤大小而言，高风险组的1期-EEC患者，应密切监测Ki-67和级别是否复发。定义1期EEC患者复发的预后因素可能会导致随访算法的变化。
