Geburtshilfe Frauenheilkd 2020; 80(10): e83
DOI: 10.1055/s-0040-1717186
Vortrag
Freitag, 9.10.2020
Neue Konzepte in der Therapie des Endometriumkarzinoms

Malignant peritoneal cytology and decreased survival of women with stage I endometrioid endometrial cancer

M Klar
1   Frauenklinik des Universitätsklinikums Freiburg, Gynäkologie und Gynäkologische Onkologie, Freiburg, Deutschland
,
S Matsuzaki
2   University of Southern California, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Los Angeles, Vereinigte Staaten von Amerika
,
DJ Nusbaum
2   University of Southern California, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Los Angeles, Vereinigte Staaten von Amerika
,
H Machida
3   Tokai University School of Medicine, Department of Obstetrics and Gynecology, Kanagawa, Japan
,
Y Nagase
4   Osaka University School of Medicine, Department of Obstetrics and Gynecology, Osaka, Japan
,
BH Grubbs
5   University of Southern California, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Los Angeles, Vereinigte Staaten von Amerika
,
LD Roman
2   University of Southern California, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Los Angeles, Vereinigte Staaten von Amerika
,
JD Wright
6   Columbia University College of Physicians and Surgeons, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York, Vereinigte Staaten von Amerika
,
P Harter
7   Kliniken Essen-Mitte (KEM) Evang. Huyssens-Stiftung/Knappschaft GmbH, Department of Gynecology and Gynecologic Oncology, Essen, Deutschland
,
K Matsuo
2   University of Southern California, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Los Angeles, Vereinigte Staaten von Amerika
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Background To examine the association between malignant peritoneal cytology and survival in women with early-stage endometrioid endometrial cancer.

Methods This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program from 2010-2016. Women with stage I endometrioid endometrial cancer who had peritoneal cytology testing at hysterectomy were examined (N = 24,800). Characteristics and survival related to malignant peritoneal cytology were assessed. Propensity score inverse probability of treatment weighting was used to balance the measured covariates.

Findings Malignant peritoneal cytology was reported in 1,081 (4.4 %) women. In multivariable analysis, stage IB disease and moderately-/poorly-differentiated tumors were associated with an increased likelihood of malignant peritoneal cytology (both, P < 0.05). In a weighted model, malignant peritoneal cytology was associated with decreased cause-specific survival (5-year rates, 92.1 % versus 96.8 %, hazard ratio [HR] 2.32, 95 % confidence interval [CI] 1.81-2.94) and overall survival (89.4 % versus 93.1 %, HR 1.52, 95 %CI 1.25-1.85). In sensitivity analyses, malignant peritoneal cytology was associated with decreased overall survival in the high-intermediate risk group (5-year rates, 77.9 % versus 83.4 %, HR 1.56, 95 %CI 1.19-2.05) and decreased cause-specific survival in the low risk group (95.4 % versus 98.0 %, HR 1.90, 95 %CI 1.17-3.20). In the high-intermediate risk group with malignant peritoneal cytology, postoperative chemotherapy was associated with improved overall survival compared to whole pelvic radiotherapy (5-year rates, 85.8 % versus 68.7 %, HR 0.35, 95 %CI 0.13-0.90). This association was not observed in negative cytology cases (81.5 % versus 79.7 %, HR 0.78, 95 %CI 0.53-1.14).

Interpretation Malignant peritoneal cytology is associated with decreased survival in stage I endometrioid endometrial cancer.



Publication History

Article published online:
07 October 2020

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