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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2014

01-12-2014 | Gynecologic Oncology

A Risk Scoring System to Determine Recurrence in Early-Stage Type 1 Endometrial Cancer: A French Multicentre Study

Authors: Sofiane Bendifallah, MD, Geoffroy Canlorbe, MD, Florence Huguet, MD, PhD, Charles Coutant, MD, PhD, Delphine Hudry, MD, Olivier Graesslin, MD, PhD, Emilie Raimond, MD, Cyril Touboul, MD, PhD, Pierre Collinet, MD, PhD, Géraldine Bleu, MD, Emile Daraï, MD, PhD, Marcos Ballester, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2014

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Abstract

Background

To develop a risk scoring system (RSS) to determine recurrence in women with early-stage type 1 endometrial cancer (EC).

Methods

Data of 396 women with early-stage type 1 EC who received primary surgical treatment between January 2001 and December 2012 were abstracted from multicentre database (training set). A risk model for predicting recurrence was developed and internally validated with the bootstrap technique. The RSS was externally validated using data from an independent population.

Results

Overall, the recurrence rate was 12.1 %. The median follow-up and initial time to recurrence were 34 (range 1–152) and 26 (range 1–151) months, respectively. Recurrence was associated with five variables: age ≥60 years, histological grade III, primary tumor diameter >2 cm, depth of myometrial invasion ≥50 %, and the positive lymphovascular space involvement status. These variables were included in the RSS and assigned scores. A total score of 6.5 points corresponded to the optimal threshold of the RSS. For women with a score <6.5 or ≥6.5, the recurrence rates were 8.4 % (30/357) and 48.7 % (19/39) in the training set, respectively. At this threshold, the diagnostic accuracy of the RSS was 87 %. Areas under the curve of the receiver-operating characteristics for predicting recurrence at internal and external validation were 0.74 [95 % confidence interval (CI) 0.71–0.77] and 0.82 (95 % CI 79–85), respectively.

Conclusions

This RSS identified two subsets of women with low and high risk of recurrence among women with early-stage type 1 EC. It could be helpful to better define indications for nodal staging and adjuvant therapy.
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Metadata
Title
A Risk Scoring System to Determine Recurrence in Early-Stage Type 1 Endometrial Cancer: A French Multicentre Study
Authors
Sofiane Bendifallah, MD
Geoffroy Canlorbe, MD
Florence Huguet, MD, PhD
Charles Coutant, MD, PhD
Delphine Hudry, MD
Olivier Graesslin, MD, PhD
Emilie Raimond, MD
Cyril Touboul, MD, PhD
Pierre Collinet, MD, PhD
Géraldine Bleu, MD
Emile Daraï, MD, PhD
Marcos Ballester, MD, PhD
Publication date
01-12-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3864-6

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