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 Ezendam, R F Kruitwagen, J M Pijnenborg, H Hollema, H W Nijman, M.A. van der Aa

OnderzoeksoutputAcademicpeer review

4 Citaten (Scopus)


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. (C) 2017 Elsevier Ltd. All rights reserved.

Originele taal-2English
Pagina's (van-tot)82-90
Aantal pagina's9
TijdschriftEuropean Journal of Cancer
StatusPublished - jun.-2017

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