Dataset Information

Analysis of Systemic Inflammatory Factors and Survival Outcomes in Endometrial Cancer Patients Staged I-III FIGO and Treated with Postoperative External Radiotherapy.

ABSTRACT: BACKGROUND:The causal link between elevated systemic inflammation biomarkers and poor survival has been demonstrated in cancer patients. However, the evidence for this correlation in endometrial cancer (EC) is too weak to influence current criteria of risk assessment. Here, we examined the role of inflammatory indicators as a tool to identify EC patients at higher risk of death in a retrospective observational study. METHODS:A total of 155 patients surgically diagnosed with EC stage I-III FIGO 2009 and treated with postoperative External Beam Radiotherapy (EBRT) ± brachytherapy and chemotherapy according to ESMO-ESTRO-ESGO recommendation for patients at high risk of recurrence at the Gustave Roussy Institut, France, and Hospital Clínic, Spain, between 2008 and 2017 were evaluated. The impact of pre-treatment Neutrophil-to-Lymphocyte Ratio (NLR ? 2.2), Monocyte-to-Lymphocyte Ratio (MLR ? 0.18), Systemic Immune-Inflammatory Index (SII ? 1100) and lymphopenia (<1.0×109/L) on overall survival (OS), cancer-specific survival and progression-free survival was evaluated. Subsequently, a cohort of 142 patients within high-advanced risk groups according to ESMO-ESGO-ESTRO classification was evaluated. RESULTS:On univariate analysis, NLR (HR = 2.2, IC 95% 1.1-4.7), SII (HR = 2.2, IC 95% 1.1-4.6), MLR (HR = 5.0, IC 95% 1.1-20.8) and lymphopenia (HR = 3.8, IC 95% 1.6-9.0) were associated with decreased OS. On multivariate analysis, NLR, MLR, SII and lymphopenia proved to be independent unfavorable prognostic factors. CONCLUSIONS:lymphopenia and lymphocytes-related ratio are associated with poorer outcome in surgically staged I-III FIGO EC patients classified as high risk and treated with adjuvant EBRT and could be considered at cancer diagnosis. External validation in an independent cohort is required before implementation for patients' stratification.

SUBMITTER: Holub K

PROVIDER: S-EPMC7291051 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Analysis of Systemic Inflammatory Factors and Survival Outcomes in Endometrial Cancer Patients Staged I-III FIGO and Treated with Postoperative External Radiotherapy.

Holub Katarzyna K Busato Fabio F Gouy Sebastien S Sun Roger R Pautier Patricia P Genestie Catherine C Morice Philippe P Leary Alexandra A Deutsch Eric E Haie-Meder Christine C Biete Albert A Chargari Cyrus C

Journal of clinical medicine 20200512 5

<h4>Background</h4>The causal link between elevated systemic inflammation biomarkers and poor survival has been demonstrated in cancer patients. However, the evidence for this correlation in endometrial cancer (EC) is too weak to influence current criteria of risk assessment. Here, we examined the role of inflammatory indicators as a tool to identify EC patients at higher risk of death in a retrospective observational study.<h4>Methods</h4>A total of 155 patients surgically diagnosed with EC sta ...[more]

PMID: 32408668

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Project description:BACKGROUND:Since intensity-modulated radiation therapy (IMRT) has become popular for the treatment of gynecologic cancers, the contouring process has become more critical. This study evaluated the feasibility of atlas-based auto-segmentation (ABAS) for contouring in patients with endometrial and cervical cancers. METHODS:A total of 75 sets of planning CT images from 75 patients were collected. Contours for the pelvic nodal clinical target volume (CTV), femur, and bladder were carefully generated by two skilled radiation oncologists. Of 75 patients, 60 were randomly registered in three different atlas libraries for ABAS in groups of 20, 40, or 60. ABAS was conducted in 15 patients, followed by manual correction (ABASc). The time required to generate all contours was recorded, and the accuracy of segmentation was assessed using Dice's coefficient (DC) and the Hausdorff distance (HD) and compared to those of manually delineated contours. RESULTS:For ABAS-CTV, the best results were achieved with groups of 60 patients (DC, 0.79; HD, 19.7?mm) and the worst results with groups of 20 patients (DC, 0.75; p?=?0.012; HD, 21.3?mm; p?=?0.002). ABASc-CTV performed better than ABAS-CTV in terms of both HD and DC (ABASc [n?=?60]; DC, 0.84; HD, 15.6?mm; all p?<?0.017). ABAS required an average of 45.1?s, whereas ABASc required 191.1?s; both methods required less time than the manual methods (p?<?0.001). Both ABAS-Femur and simultaneous ABAS-Bilateral-femurs showed satisfactory performance, regardless of the atlas library used (DC >?0.9 and HD ?10.0?mm), with significant time reduction compared to that needed for manual delineation (p?<?0.001). However, ABAS-Bladder did not prove to be feasible, with inferior results regardless of library size (DC?<?0.6 and HD?>?40?mm). Furthermore, ABASc-Bladder required a longer processing time than manual contouring to achieve the same accuracy. CONCLUSIONS:ABAS could help physicians to delineate the CTV and organs-at-risk (e.g., femurs) in IMRT planning considering its consistency, efficacy, and accuracy.

Dataset Information

Analysis of Systemic Inflammatory Factors and Survival Outcomes in Endometrial Cancer Patients Staged I-III FIGO and Treated with Postoperative External Radiotherapy.

Publications

Analysis of Systemic Inflammatory Factors and Survival Outcomes in Endometrial Cancer Patients Staged I-III FIGO and Treated with Postoperative External Radiotherapy.

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