Methods
3751 patients with endometrial cancer diagnosed in Obstetrics and Gynecology Hospital of Fudan University were enrolled from Jan. 2009 to April. 2019. patients who did not receive comprehensive staging surgery (n=2516), with unknown/inconsistent pathologic staging (n=80), or unknown endometrioid histology type (n=331) were excluded. Finally, 1235 EEC patients were analyzed to hunt for the significant clinicopathological risk factors. 854 patients were excluded for survival analysis due to missing follow-up information, therefore, only 381 patients were included for survival analysis from Jan. 2009 to June. 2018.
Among 1235 EEC patients, univariable and multivariable analysis were done for risk factor analysis. These factors included age, Endo, Microcystic, Elongated, and Fragmented (MELF) pattern of invasion, stage, lymph vascular space invasion (LVSI), cervical stroma involvement (CSI), adnexal involvement (AI), parametrium involvement (PI), tumor size (TS), and myometrium invasion (MI). Then we stratified risk factors which strongly related to lymph node LNM rates in grade 3 patients.
The primary end-point was defined as death, overall survival (OS) was defined as the time from the date of diagnosis until death or last follow-up till June. 2018. The secondary endpoint was endometrial cancer recurrence, and progression-free survival (PFS) estimates were also assessed. Medical records were reviewed to determine OS and PFS according to the status of lymph node metastasis.
Variables were evaluated by Pearson Chi2 test and Yates’ adjusted Chi2 test. Binary regression models were used for multivariate analysis. survival outcomes were indicated with OS and PFS. While survival rates were estimated using Kaplan-Meier method, the log-rank test was utilized to draw survival curve. Statistical analysis was performed with STATA 15.0 and Prism 8.