title: Histologic grade and peritoneal cytology as prognostic factors in type 1 endometrial cancer.
abstract: BACKGROUND
  Prognostic clinicopathological factors for type 1 endometrial cancer are unknown and the purpose of the current study was to determine the independent prognostic variables for type 1 endometrial cancer.
  
  
  METHODS
  We performed a retrospective study of 168 patients with type 1 endometrial cancer primarily treated with comprehensive staging surgery. The median follow-up time was 68 (12-100) months. Independent risk factors for disease-free survival (DFS) and overall survival (OS) were determined using multivariate Cox regression models. Sub-group analysis of stage I was also performed. We also assessed the patterns of failure among patients with recurrences and investigated the associations with the prognostic variables determined by multivariate analysis.
  
  
  RESULTS
  Twenty patients (11.9%) had recurrence and 13 patients (7.7%) died of the disease overall. Multivariate analysis revealed that grade 2 (G2) histology (p = 0.008) and positive peritoneal cytology (p = 0.001) predicted the recurrent event in type 1 endometrial cancer. G2 histology (p = 0.007) and positive peritoneal cytology (p = 0.003) were also found to be independent risk factors for tumor-related deaths. Among stage I patients, G2 histology and positive peritoneal cytology were also independent prognostic variables for DFS and OS. Patients with G2 histology and/or positive peritoneal cytology were more likely to have recurrence at distant sites.
  
  
  CONCLUSIONS
  G2 histology and positive peritoneal cytology were independent prognostic factors for DFS and OS in type 1 endometrial cancer.
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. yoichi@ks.kyorin-u.ac.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: The Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
authors.forename: Juri
authors.initials: J
authors.lastname: Sugiyama
authors.affiliation: The Japanese Red Cross Musashino Hospital, Musashino, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamazaki
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Dozono
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Momoe
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shibuya
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nishigaya
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Momomura
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: The Japanese Red Cross Musashino Hospital, Musashino, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umezawa
authors.affiliation: The Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takamatsu
authors.affiliation: Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Iwashita
mesh_terms: D000368:Aged; D003581:Cytodiagnosis; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Endometrial cancer; Peritoneal cytology; Prognostic factor; Tumor grade; Type1