Objective. To evaluate treatment outcomes in women with early-stage endometrial cancer (FIGO IA, IB, IC, or IIA)-surgically managed by a general gynecologist (GYN) or a gynecologic oncologist (GYO). Methods and result...Objective. To evaluate treatment outcomes in women with early-stage endometrial cancer (FIGO IA, IB, IC, or IIA)-surgically managed by a general gynecologist (GYN) or a gynecologic oncologist (GYO). Methods and results. 349 women treated from 1990-2003 were studied. Median follow-up was 3.7 years. Ninety-five were classified as highintermediate risk (HIR: stages IB grade III, IC grade II or III, any stage IIA). 110 women received adjuvant radiotherapy. The GYO group had more unfavorable tumor characteristics based on stage and grade (P < 0.0001), shorter follow-up (median 3.1 vs. 5.1 years, P = 0.0002), and an absolute 12%less likelihood of receiving adjuvant radiotherapy (P = 0.04). Local and distant failures were not significantly different. Overall survival favored GYN patients (P = 0.02) with no difference in disease-specific survival (P = 0.38). Multivariate analysis for disease-free survival revealed HIR disease (P = 0.04) and GYO treatment (P = 0.049) to be significant, with a trend for age ≤64 (P = 0.05). Multivariate analysis for overall survival found age ≤64 (P = 0.0001), HIR disease (P = 0.01), and adjuvant radiotherapy (P = 0.0055) to be significant. Conclusions. Women primarily managed by a GYO for early-stage disease were significantly less likely to receive adjuvant radiotherapy. Despite significantly more unfavorable disease characteristics among GYO-managed women,disease-free and cause-specific survival were equivalent between the two groups. Favorable disease characteristics and adjuvant radiotherapy correlated with improved survival on multivariate analysis.展开更多
Objective. To investigate prognostic significance of and correlations between HER1 (EGFR), HER2 (c-erb-B2), HER3 (c-erb-B3), HER4 (c-erb-B4), and phosphorylated Akt (P-Akt) in patients treated with radiation for cervi...Objective. To investigate prognostic significance of and correlations between HER1 (EGFR), HER2 (c-erb-B2), HER3 (c-erb-B3), HER4 (c-erb-B4), and phosphorylated Akt (P-Akt) in patients treated with radiation for cervical carcinoma. Methods. Fifty-five patients with stages I-IVA cervical carcinoma were treated with definitive radiotherapy. Tumor expression of each biomarker was quantitatively scored by an automated immunohistochemical imaging system. Parametric correlations were performed between biomarkers. Univariate and multivariate analysis was performed with disease-free survival (DFS) and overall survival (OS) as primary endpoints. Results. Correlations were observed between expression of HER2 and HER4 (P = 0.003), and HER3 and HER4 (P = 0.004). Decreased HER2, HER4, and P-Akt expressions were significant for diminished DFS on univariate analysis (P = 0.04, P = 0.008, and P = 0.02, respectively). Increased EGFR, and diminished HER2, HER4, and P-Akt expression were significant or showed trends toward significance for diminished OS on univariate analysis (P = 0.07, P = 0.008, P = 0.09, and P = 0.08, respectively). After controlling for pretreatment factors, multivariate analysis revealed HER2 associated with improved OS (P = 0.05). Thesedata emphasize that significant correlations exist between the differential expression of various HER family receptors. Multivariate analysis revealed only increased HER2 expression associated with improved OS after controlling for pretreatment clinical factors. Conclusions. These data emphasize the importance of continued basic and translational research on the HER family of receptors in cervical carcinoma.展开更多
文摘Objective. To evaluate treatment outcomes in women with early-stage endometrial cancer (FIGO IA, IB, IC, or IIA)-surgically managed by a general gynecologist (GYN) or a gynecologic oncologist (GYO). Methods and results. 349 women treated from 1990-2003 were studied. Median follow-up was 3.7 years. Ninety-five were classified as highintermediate risk (HIR: stages IB grade III, IC grade II or III, any stage IIA). 110 women received adjuvant radiotherapy. The GYO group had more unfavorable tumor characteristics based on stage and grade (P < 0.0001), shorter follow-up (median 3.1 vs. 5.1 years, P = 0.0002), and an absolute 12%less likelihood of receiving adjuvant radiotherapy (P = 0.04). Local and distant failures were not significantly different. Overall survival favored GYN patients (P = 0.02) with no difference in disease-specific survival (P = 0.38). Multivariate analysis for disease-free survival revealed HIR disease (P = 0.04) and GYO treatment (P = 0.049) to be significant, with a trend for age ≤64 (P = 0.05). Multivariate analysis for overall survival found age ≤64 (P = 0.0001), HIR disease (P = 0.01), and adjuvant radiotherapy (P = 0.0055) to be significant. Conclusions. Women primarily managed by a GYO for early-stage disease were significantly less likely to receive adjuvant radiotherapy. Despite significantly more unfavorable disease characteristics among GYO-managed women,disease-free and cause-specific survival were equivalent between the two groups. Favorable disease characteristics and adjuvant radiotherapy correlated with improved survival on multivariate analysis.
文摘Objective. To investigate prognostic significance of and correlations between HER1 (EGFR), HER2 (c-erb-B2), HER3 (c-erb-B3), HER4 (c-erb-B4), and phosphorylated Akt (P-Akt) in patients treated with radiation for cervical carcinoma. Methods. Fifty-five patients with stages I-IVA cervical carcinoma were treated with definitive radiotherapy. Tumor expression of each biomarker was quantitatively scored by an automated immunohistochemical imaging system. Parametric correlations were performed between biomarkers. Univariate and multivariate analysis was performed with disease-free survival (DFS) and overall survival (OS) as primary endpoints. Results. Correlations were observed between expression of HER2 and HER4 (P = 0.003), and HER3 and HER4 (P = 0.004). Decreased HER2, HER4, and P-Akt expressions were significant for diminished DFS on univariate analysis (P = 0.04, P = 0.008, and P = 0.02, respectively). Increased EGFR, and diminished HER2, HER4, and P-Akt expression were significant or showed trends toward significance for diminished OS on univariate analysis (P = 0.07, P = 0.008, P = 0.09, and P = 0.08, respectively). After controlling for pretreatment factors, multivariate analysis revealed HER2 associated with improved OS (P = 0.05). Thesedata emphasize that significant correlations exist between the differential expression of various HER family receptors. Multivariate analysis revealed only increased HER2 expression associated with improved OS after controlling for pretreatment clinical factors. Conclusions. These data emphasize the importance of continued basic and translational research on the HER family of receptors in cervical carcinoma.
