COX MULTIVARIATE REGRESSION-MODELS FOR ESTIMATING PROGNOSIS OF PATIENTS WITH ENDOMETRIOID ADENOCARCINOMA OF THE UTERINE CORPUS WHO UNDERWENT THOROUGH SURGICAL STAGING

The International Federation of Gynecology and Obstetrics (FIGO) adopt ed surgical staging criteria in 1988. Many studies have shown that his tologic grade, nuclear grade, lymphvascular space invasion and cell ty pe are also important predictors of survival. It has not been clarifie d, however, how to integrate these histopathologic variables into the process of estimating individual prognosis. We performed Cox multivari ate regression analysis to create models that incorporate various hist opathologic factors for estimating the prognoses of patients with endo metrioid adenocarcinoma of the uterine corpus. Our study was based on data from 206 patients who underwent complete surgical staging, includ ing systematic pelvic and para-aortic lymph node dissection. Two model s resulted: one included depth of myometrial invasion, paraaortic node metastasis and the number of sites involved by the tumor among the ce rvix, ovary and pelvic lymph nodes (which we designated as extracorpor eal spread score, ECS) and the other incorporated nuclear grade and ly mph-vascular space invasion as variables. These 2 models enabled the p rognosis for patients with endometrioid adenocarcinoma to be stratifie d into several levels according to hazard ratio. Comprehensive integra tion of the histopathologic prognostic factors, categorized into those relating to tumor extent and those relating to tumor virulence, shoul d facilitate the estimation of individual prognosis more accurately th an FIGO staging alone. Int. J. Cancer (Pred. Oncol.) 79:521-525, 1998. (C) 1998 Wiley-Liss, Inc.