Hematogenous Dissemination in Corpus Cancer
Hematogenous Dissemination in Corpus Cancer
Mariani A, Webb MJ, Keeney GL, et al. Gynecol Oncol. 2001;80:233-238.
This study sought to assess the predictors of hematogenous dissemination (HD) in corpus cancer. We defined HD as tumor spread to the lung, liver, or other sites via hematogenous routes in 612 corpus cancer patients who were managed surgically.
A total of 142 instances of tumor spread were observed: 71 were nonhematogenous; 42 were hematogenous to the lung, 9 to the liver, 5 to other sites (adrenals, breast, brain, bone, skin), 3 to both liver and lung, 1 to both lung and bone, and 11 to unidentified sites.
Deep myometrial invasion was the only independent predictor of HD. Stage IV disease, positive adnexa, deep myometrial invasion, primary tumor diameter, tumor involving the whole uterine cavity, positive peritoneal cytology, adjuvant radiotherapy, adjuvant chemotherapy, grade 3 histology, histologic subtype, and lymphovascular invasion, however, significantly correlated with HD (P ≤ .01).
Only 5% of cases with 50% or less myometrial invasion had HD compared with 23% with greater than 50% myometrial invasion. When recurrence in the lung and recurrence in the liver and other sites were looked at separately, the only independent predictors of lung recurrence were stage IV disease and myometrial invasion. Age and histologic grade were independent predictors of HD to the liver and other sites.
In looking at the 60 patients who had a known site of HD, we found that 67% of those whose disease recurred in the lung were more than 65 years old, compared with 17% of those whose disease had HD to the liver or other sites. Furthermore, grade 1 or 2 disease was observed in 65% of patients with lung recurrence compared with 27% of those whose disease had HD to the liver or other sites.
The presence of deep myometrial invasion was the strongest predictor of HD in corpus cancer, and, together with stage IV disease, it independently predicted lung recurrence. Recurrence in the lung was more frequent in older patients with well or moderately differentiated tumors, whereas HD to the liver or other sites was more frequent in patients who were aged 65 years or younger and harbored grade 3 tumors.
Mariani A, Webb MJ, Keeney GL, et al. Gynecol Oncol. 2001;80:233-238.
This study sought to assess the predictors of hematogenous dissemination (HD) in corpus cancer. We defined HD as tumor spread to the lung, liver, or other sites via hematogenous routes in 612 corpus cancer patients who were managed surgically.
A total of 142 instances of tumor spread were observed: 71 were nonhematogenous; 42 were hematogenous to the lung, 9 to the liver, 5 to other sites (adrenals, breast, brain, bone, skin), 3 to both liver and lung, 1 to both lung and bone, and 11 to unidentified sites.
Deep myometrial invasion was the only independent predictor of HD. Stage IV disease, positive adnexa, deep myometrial invasion, primary tumor diameter, tumor involving the whole uterine cavity, positive peritoneal cytology, adjuvant radiotherapy, adjuvant chemotherapy, grade 3 histology, histologic subtype, and lymphovascular invasion, however, significantly correlated with HD (P ≤ .01).
Only 5% of cases with 50% or less myometrial invasion had HD compared with 23% with greater than 50% myometrial invasion. When recurrence in the lung and recurrence in the liver and other sites were looked at separately, the only independent predictors of lung recurrence were stage IV disease and myometrial invasion. Age and histologic grade were independent predictors of HD to the liver and other sites.
In looking at the 60 patients who had a known site of HD, we found that 67% of those whose disease recurred in the lung were more than 65 years old, compared with 17% of those whose disease had HD to the liver or other sites. Furthermore, grade 1 or 2 disease was observed in 65% of patients with lung recurrence compared with 27% of those whose disease had HD to the liver or other sites.
The presence of deep myometrial invasion was the strongest predictor of HD in corpus cancer, and, together with stage IV disease, it independently predicted lung recurrence. Recurrence in the lung was more frequent in older patients with well or moderately differentiated tumors, whereas HD to the liver or other sites was more frequent in patients who were aged 65 years or younger and harbored grade 3 tumors.
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