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首页> 外文期刊>Gynecologic Oncology Reports >Associated characteristics and impact on recurrence and survival of free-floating tumor fragments in the lumen of fallopian tubes in Type I and Type II endometrial cancer
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Associated characteristics and impact on recurrence and survival of free-floating tumor fragments in the lumen of fallopian tubes in Type I and Type II endometrial cancer

机译：I型和II型子宫内膜癌输卵管腔内自由漂浮肿瘤片段的相关特征及其对复发和生存的影响

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Objective This study sought to evaluate characteristics of cases of free-floating tumor fragments within the lumen of fallopian tubes (‘floaters’) on final pathology for Type I and Type II endometrial adenocarcinoma, including relationships with disease recurrence and mortality. Methods A single institution experience of 1022 consecutive cases of uterine cancer presenting between 2005 and 2010 was retrospectively reviewed, with data extraction from electronic medical records. Associations of floaters with baseline characteristics were studied with logistic regression, and relationships with disease recurrence and survival were assessed with Cox proportional hazards models. Results Among 816 included cases of Type I or Type II endometrial adenocarcinoma, floaters were identified on final pathology for 20 patients (2.5%). Patient characteristics of cases with floaters mirrored the overall sample. With adjustment, presence of floaters trended towards association with laparoscopic/robotic approach (OR=3.84; 95%CI 0.98-15.1), and was significantly associated with lymphovascular invasion (OR=9.65; 95%CI 2.35-39.6) and higher stage disease. Although floaters were associated with increased risk of recurrence in unadjusted analysis (HR=3.22; 95%CI 1.41-7.37), after adjustment for disease type, stage, and patient comorbidities, no evidence for impact on disease recurrence or overall survival was found. Conclusions The presence of floaters is rare. Floaters were generally associated with more extensive disease, but no evidence was found to show any independent prognostic impact on risk of recurrence or death. In agreement with prior research, this study found a trend towards association of floaters with laparoscopic/robotic approach, indicating the possibility of floaters sometimes being the result of trauma from uterine manipulator insertion. Highlights ? Floaters are defined as free floating tumor fragments within the fallopian tubes. ? Floaters are uncommon, but had previously unknown prognostic significance. ? Presence of floaters was associated with higher stage and lymphovascular invasion. ? Floaters may be associated with laparoscopy due to trauma from uterine manipulation. ? Floaters are not associated with increased chance of recurrence or death.
机译：目的本研究旨在评估I型和II型子宫内膜腺癌的最终病理学特征，以评估输卵管腔（“漂浮物”）内游离漂浮的肿瘤碎片的特征，包括与疾病复发和死亡率的关系。方法回顾性分析2005年至2010年间连续发生的1022例子宫癌病例的单机构经验，并从电子病历中提取数据。用逻辑回归研究浮子与基线特征的相关性，并用Cox比例风险模型评估与疾病复发和生存的关系。结果在816例包括I型或II型子宫内膜腺癌的病例中，有20名患者（2.5％）在最终病理中发现了漂浮物。带浮子的病例的患者特征反映了整个样本。通过调整，漂浮物的存在倾向于与腹腔镜/机器人方法（OR = 3.84; 95％CI 0.98-15.1）关联，并且与淋巴管浸润（OR = 9.65; 95％CI 2.35-39.6）和更高阶段的疾病显着相关。尽管在未经调整的分析中，漂浮物与复发风险增加相关（HR = 3.22; 95％CI 1.41-7.37），但在对疾病类型，阶段和患者合并症进行调整后，没有发现对疾病复发或总体生存产生影响的证据。结论漂浮物很少出现。浮游动物通常与更广泛的疾病有关，但没有证据显示对复发或死亡的风险有任何独立的预后影响。与先前的研究一致，本研究发现了漂浮物与腹腔镜/机械手方法相关联的趋势，表明漂浮物的可能性有时是由于子宫操纵器插入而造成的。强调 ？漂浮物被定义为输卵管内的游离漂浮肿瘤片段。 ？漂浮物并不常见，但其预后意义尚不明确。 ？漂浮物的存在与更高阶段和淋巴血管的侵袭有关。 ？由于子宫操作造成的创伤，漂浮物可能与腹腔镜检查有关。 ？漂浮物与复发或死亡的机会增加无关。

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