Gynecologic oncology · 2025
Prospective assessment of prognostic significance of malignant peritoneal cytology in endometrial cancer: An NRG Oncology / Gynecologic Oncology Group study on GOG-210 protocol.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Matsuo Koji, Enserro Danielle M, Wright Jason D, Roman Lynda D, Powell Matthew A, Miller David S, Nagel Christa I, Thaker Premal H, Mannel Robert S, Stuckey Ashley R, Guntupalli Saketh R, Sukumvanich Paniti, Geller Melissa A, Vargas Roberto, Konecny Gottfried E, Warshal David P, Tewari Krishnansu S, Spirtos Nick M, Pothuri Bhavana, Creasman William T, Mutch David G
Аннотация
OBJECTIVE: To examine the association between malignant peritoneal cytology and survival outcomes in endometrial cancer.
METHODS: This was an ancillary analysis of prospectively collected surgical-pathological data in the NRG Oncology / Gynecologic Oncology Group study on GOG-210 protocol. The study population included 2383 patients with stage I-III endometrial cancer from 2003 to 2011. Exposure was peritoneal cytology status: malignant peritoneal cytology (n = 215) or negative peritoneal cytology (n = 2168). Main outcome measures were recurrence-free survival and overall survival. Propensity score inverse probability treatment weighting was performed to balance the baseline clinico-pathological characteristics, followed by adjustment for adjuvant therapy.
RESULTS: Malignant peritoneal cytology was associated with a 32% increased risk of recurrence (5-year rates, 72% versus 77%, hazard ratio 1.32, 95% confidence interval 1.03 to 1.69, P = 0.028) and 37% increased risk of all-cause mortality (78% versus 83%, hazard ratio 1.37, 95% confidence interval 1.06 to 1.78, P = 0.018) compared to negative peritoneal cytology. When controlling for adjuvant therapy, the association between malignant peritoneal cytology and survival was attenuated for both recurrence-free survival (adjusted-hazard ratio 1.16, 95% confidence interval 0.90 to 1.50, P = 0.24) and overall survival (adjusted-hazard ratio 1.22, 95% confidence interval 0.93 to 1.60, P = 0.16) without statistical significance. Peritoneal cytology status and adjuvant therapy type had a possible interaction on overall survival, and malignant peritoneal cytology was associated with decreased overall survival when radiotherapy was received as adjuvant therapy but not when chemotherapy was utilized (P-interaction = 0.059).
CONCLUSION: The results of this prospective assessment suggest that malignant peritoneal cytology is a prognostic factor, if any, associated with a modest decrease in survival for endometrial cancer.
METHODS: This was an ancillary analysis of prospectively collected surgical-pathological data in the NRG Oncology / Gynecologic Oncology Group study on GOG-210 protocol. The study population included 2383 patients with stage I-III endometrial cancer from 2003 to 2011. Exposure was peritoneal cytology status: malignant peritoneal cytology (n = 215) or negative peritoneal cytology (n = 2168). Main outcome measures were recurrence-free survival and overall survival. Propensity score inverse probability treatment weighting was performed to balance the baseline clinico-pathological characteristics, followed by adjustment for adjuvant therapy.
RESULTS: Malignant peritoneal cytology was associated with a 32% increased risk of recurrence (5-year rates, 72% versus 77%, hazard ratio 1.32, 95% confidence interval 1.03 to 1.69, P = 0.028) and 37% increased risk of all-cause mortality (78% versus 83%, hazard ratio 1.37, 95% confidence interval 1.06 to 1.78, P = 0.018) compared to negative peritoneal cytology. When controlling for adjuvant therapy, the association between malignant peritoneal cytology and survival was attenuated for both recurrence-free survival (adjusted-hazard ratio 1.16, 95% confidence interval 0.90 to 1.50, P = 0.24) and overall survival (adjusted-hazard ratio 1.22, 95% confidence interval 0.93 to 1.60, P = 0.16) without statistical significance. Peritoneal cytology status and adjuvant therapy type had a possible interaction on overall survival, and malignant peritoneal cytology was associated with decreased overall survival when radiotherapy was received as adjuvant therapy but not when chemotherapy was utilized (P-interaction = 0.059).
CONCLUSION: The results of this prospective assessment suggest that malignant peritoneal cytology is a prognostic factor, if any, associated with a modest decrease in survival for endometrial cancer.