Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification

F. A. Eggink; C. H. Mom; K. Bouwman; D. Boll; J. H. Becker; C. L. Creutzberg; G. C. Niemeijer; W. J. van Driel; A. K. Reyners; A. G. van der Zee; G. L. Bremer; N. P. Ezendam; R. F. Kruitwagen; J. M. Pijnenborg; H. Hollema; H. W. Nijman; M. A. van der Aa

doi:10.1016/j.ejca.2017.03.010

Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification

F. A. Eggink, C. H. Mom, K. Bouwman, D. Boll, J. H. Becker, C. L. Creutzberg, G. C. Niemeijer, W. J. van Driel, A. K. Reyners, A. G. van der Zee, G. L. Bremer, N. P. Ezendam, R. F. Kruitwagen, J. M. Pijnenborg, H. Hollema, H. W. Nijman^*, M. A. van der Aa

^*Corresponding author for this work

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Abstract

Background: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival.

Methods: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre-and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients.

Results: A discordant risk stratification was found in 10% of patients: 4% (N = 155) had high pre-and low post-operative risk and 6% (N = 215) had low pre-and high post-operative risk. Overall survival of patients with high pre-and low post-operative risk was less favourable compared to those with a concordant low risk (80% versus 89%, p = 0.002). This difference remained significant when correcting for age, stage, surgical staging and adjuvant therapy (hazard ratio 1.80, 95% confidence interval 1.28-2.53, p = 0.001). Survival of patients with low pre-and high post-operative risk did not differ from those with a concordant high risk (64% versus 62%, p = 0.295).

Conclusion: Patients with high pre-and low post-operative risk have a less favourable prognosis compared to patients with a concordant low risk. Pre-operative risk stratifications contain independent prognostic information and should be incorporated into clinical decision-making. (C) 2017 Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	82-90
Number of pages	9
Journal	European Journal of Cancer
Volume	78
DOIs	https://doi.org/10.1016/j.ejca.2017.03.010
Publication status	Published - Jun 2017

Keywords

Endometrial cancer
Risk stratification
Histology
Clinical decision-making
Overall survival
EXTERNAL-BEAM RADIOTHERAPY
LYMPH-NODE METASTASIS
RANDOMIZED-TRIAL
OVARIAN-CANCER
CARCINOMA
CLASSIFICATION
CHEMOTHERAPY
METAANALYSIS
SPECIMENS
INVASION

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1 Erratum / corrigendum / retractions

Corrigendum to "Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre- versus post-operative risk stratification" (vol 78, pg 82, 2017)
Eggink, F. A., Mom, C. H., Bouwman, K., Boll, D., Becker, J. H., Creutzberg, C. L., Niemeijer, G. C., van Driel, W. J., Reyners, A. K., van der Zee, A. G., Bremer, G. L., Ezendam, N. P., Kruitwagen, R. F., Pijnenborg, J. M., Hollema, H., Nijman, H. W. & van der Aa, M. A., Oct 2017, In: European Journal of Cancer. 84, p. 370-370 1 p.
Research output: Contribution to journal › Erratum / corrigendum / retractions › Academic

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Eggink, F. A., Mom, C. H., Bouwman, K., Boll, D., Becker, J. H., Creutzberg, C. L., Niemeijer, G. C., van Driel, W. J., Reyners, A. K., van der Zee, A. G., Bremer, G. L., Ezendam, N. P., Kruitwagen, R. F., Pijnenborg, J. M., Hollema, H., Nijman, H. W., & van der Aa, M. A. (2017). Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification. European Journal of Cancer, 78, 82-90. https://doi.org/10.1016/j.ejca.2017.03.010

@article{3e867d163f804e19b32ee37b6044cd7a,

title = "Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification",

abstract = "Background: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival.Methods: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre-and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients.Results: A discordant risk stratification was found in 10% of patients: 4% (N = 155) had high pre-and low post-operative risk and 6% (N = 215) had low pre-and high post-operative risk. Overall survival of patients with high pre-and low post-operative risk was less favourable compared to those with a concordant low risk (80% versus 89%, p = 0.002). This difference remained significant when correcting for age, stage, surgical staging and adjuvant therapy (hazard ratio 1.80, 95% confidence interval 1.28-2.53, p = 0.001). Survival of patients with low pre-and high post-operative risk did not differ from those with a concordant high risk (64% versus 62%, p = 0.295).Conclusion: Patients with high pre-and low post-operative risk have a less favourable prognosis compared to patients with a concordant low risk. Pre-operative risk stratifications contain independent prognostic information and should be incorporated into clinical decision-making. (C) 2017 Elsevier Ltd. All rights reserved.",

keywords = "Endometrial cancer, Risk stratification, Histology, Clinical decision-making, Overall survival, EXTERNAL-BEAM RADIOTHERAPY, LYMPH-NODE METASTASIS, RANDOMIZED-TRIAL, OVARIAN-CANCER, CARCINOMA, CLASSIFICATION, CHEMOTHERAPY, METAANALYSIS, SPECIMENS, INVASION",

author = "Eggink, {F. A.} and Mom, {C. H.} and K. Bouwman and D. Boll and Becker, {J. H.} and Creutzberg, {C. L.} and Niemeijer, {G. C.} and {van Driel}, {W. J.} and Reyners, {A. K.} and {van der Zee}, {A. G.} and Bremer, {G. L.} and Ezendam, {N. P.} and Kruitwagen, {R. F.} and Pijnenborg, {J. M.} and H. Hollema and Nijman, {H. W.} and {van der Aa}, {M. A.}",

year = "2017",

month = jun,

doi = "10.1016/j.ejca.2017.03.010",

language = "English",

volume = "78",

pages = "82--90",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Ltd",

}

Eggink, FA, Mom, CH, Bouwman, K, Boll, D, Becker, JH, Creutzberg, CL, Niemeijer, GC, van Driel, WJ, Reyners, AK, van der Zee, AG, Bremer, GL, Ezendam, NP, Kruitwagen, RF, Pijnenborg, JM, Hollema, H, Nijman, HW & van der Aa, MA 2017, 'Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification', European Journal of Cancer, vol. 78, pp. 82-90. https://doi.org/10.1016/j.ejca.2017.03.010

TY - JOUR

T1 - Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification

AU - Eggink, F. A.

AU - Mom, C. H.

AU - Bouwman, K.

AU - Boll, D.

AU - Becker, J. H.

AU - Creutzberg, C. L.

AU - Niemeijer, G. C.

AU - van Driel, W. J.

AU - Reyners, A. K.

AU - van der Zee, A. G.

AU - Bremer, G. L.

AU - Ezendam, N. P.

AU - Kruitwagen, R. F.

AU - Pijnenborg, J. M.

AU - Hollema, H.

AU - Nijman, H. W.

AU - van der Aa, M. A.

PY - 2017/6

Y1 - 2017/6

N2 - Background: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival.Methods: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre-and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients.Results: A discordant risk stratification was found in 10% of patients: 4% (N = 155) had high pre-and low post-operative risk and 6% (N = 215) had low pre-and high post-operative risk. Overall survival of patients with high pre-and low post-operative risk was less favourable compared to those with a concordant low risk (80% versus 89%, p = 0.002). This difference remained significant when correcting for age, stage, surgical staging and adjuvant therapy (hazard ratio 1.80, 95% confidence interval 1.28-2.53, p = 0.001). Survival of patients with low pre-and high post-operative risk did not differ from those with a concordant high risk (64% versus 62%, p = 0.295).Conclusion: Patients with high pre-and low post-operative risk have a less favourable prognosis compared to patients with a concordant low risk. Pre-operative risk stratifications contain independent prognostic information and should be incorporated into clinical decision-making. (C) 2017 Elsevier Ltd. All rights reserved.

AB - Background: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival.Methods: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre-and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients.Results: A discordant risk stratification was found in 10% of patients: 4% (N = 155) had high pre-and low post-operative risk and 6% (N = 215) had low pre-and high post-operative risk. Overall survival of patients with high pre-and low post-operative risk was less favourable compared to those with a concordant low risk (80% versus 89%, p = 0.002). This difference remained significant when correcting for age, stage, surgical staging and adjuvant therapy (hazard ratio 1.80, 95% confidence interval 1.28-2.53, p = 0.001). Survival of patients with low pre-and high post-operative risk did not differ from those with a concordant high risk (64% versus 62%, p = 0.295).Conclusion: Patients with high pre-and low post-operative risk have a less favourable prognosis compared to patients with a concordant low risk. Pre-operative risk stratifications contain independent prognostic information and should be incorporated into clinical decision-making. (C) 2017 Elsevier Ltd. All rights reserved.

KW - Endometrial cancer

KW - Risk stratification

KW - Histology

KW - Clinical decision-making

KW - Overall survival

KW - EXTERNAL-BEAM RADIOTHERAPY

KW - LYMPH-NODE METASTASIS

KW - RANDOMIZED-TRIAL

KW - OVARIAN-CANCER

KW - CARCINOMA

KW - CLASSIFICATION

KW - CHEMOTHERAPY

KW - METAANALYSIS

KW - SPECIMENS

KW - INVASION

U2 - 10.1016/j.ejca.2017.03.010

DO - 10.1016/j.ejca.2017.03.010

M3 - Article

C2 - 28415003

SN - 0959-8049

VL - 78

SP - 82

EP - 90

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre-versus post-operative risk stratification

Abstract

Keywords

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Research output

Corrigendum to "Less-favourable prognosis for low-risk endometrial cancer patients with a discordant pre- versus post-operative risk stratification" (vol 78, pg 82, 2017)

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