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.M. Ezendam, R.f. Kruitwagen, J.m. Pijnenborg, H. Hollema, H.w. Nijman, M.a. Van Der Aa

Research output: Contribution to journalArticleScientificpeer-review

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.

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Endometrial Neoplasms
Netherlands
Confidence Intervals

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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.M. ; Kruitwagen, R.f. ; Pijnenborg, J.m. ; Hollema, H. ; Nijman, H.w. ; Van Der Aa, M.a. / Less favourable prognosis for low risk endometrial cancer patients with a discordant pre versus post operative risk stratification. In: European Journal of Cancer: Official journal for European Organization for Research and Treatment of Cancer (EORTC). 2017 ; Vol. 78. pp. 82-90.
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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.",
author = "F.a. Eggink and C.h. Mom and K. Bouwman and D. Boll and J.h. Becker and C.l. Creutzberg and G.c. Niemeijer and {Van Driel}, W.j. and A.k. Reyners and {Van Der Zee}, A.g. and G.l. Bremer and N.P.M. Ezendam and R.f. Kruitwagen and J.m. Pijnenborg and H. Hollema and H.w. Nijman and {Van Der Aa}, M.a.",
year = "2017",
month = "6",
day = "1",
doi = "10.1016/j.ejca.2017.03.010",
language = "English",
volume = "78",
pages = "82--90",
journal = "European Journal of Cancer: Official journal for European Organization for Research and Treatment of Cancer (EORTC)",
issn = "0959-8049",
publisher = "ELSEVIER SCI 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, NPM, 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: Official journal for European Organization for Research and Treatment of Cancer (EORTC), vol. 78, pp. 82-90. https://doi.org/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. / 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.M.; Kruitwagen, R.f.; Pijnenborg, J.m.; Hollema, H.; Nijman, H.w.; Van Der Aa, M.a.

In: European Journal of Cancer: Official journal for European Organization for Research and Treatment of Cancer (EORTC), Vol. 78, 01.06.2017, p. 82-90.

Research output: Contribution to journalArticleScientificpeer-review

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.M.

AU - Kruitwagen, R.f.

AU - Pijnenborg, J.m.

AU - Hollema, H.

AU - Nijman, H.w.

AU - Van Der Aa, M.a.

PY - 2017/6/1

Y1 - 2017/6/1

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.

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.

U2 - 10.1016/j.ejca.2017.03.010

DO - 10.1016/j.ejca.2017.03.010

M3 - Article

VL - 78

SP - 82

EP - 90

JO - European Journal of Cancer: Official journal for European Organization for Research and Treatment of Cancer (EORTC)

JF - European Journal of Cancer: Official journal for European Organization for Research and Treatment of Cancer (EORTC)

SN - 0959-8049

ER -