Hematogenous dissemination in corpus cancer

Area of Science:

• Gynecologic Oncology
• Oncology
• Pathology

Background:

• Corpus cancer, also known as uterine cancer, can spread to distant sites through hematogenous dissemination (HD).
• Identifying predictors of HD is crucial for improving patient outcomes and tailoring treatment strategies.

Purpose of the Study:

• To assess the predictors of hematogenous dissemination (HD) in corpus cancer patients.
• To identify factors associated with specific sites of metastasis, such as the lung versus the liver/other sites.

Main Methods:

• A cohort of 612 surgically managed corpus cancer patients was analyzed.
• Hematogenous dissemination (HD) was defined as tumor spread to the lung, liver, or other distant sites via the bloodstream.

Main Results:

• Deep myometrial invasion was the sole independent predictor of HD. Patients with >50% myometrial invasion had a significantly higher rate of HD (23%) compared to those with <=50% (5%).
• Stage IV disease and myometrial invasion independently predicted lung recurrence. Age and histologic grade predicted HD to the liver/other sites.
• Lung recurrence was more common in older patients (>65) with well-differentiated tumors (Grade 1-2), while liver/other site recurrence was more frequent in younger patients (<=65) with poorly differentiated tumors (Grade 3).

Conclusions:

• Deep myometrial invasion is the most significant predictor of HD in corpus cancer.
• Lung recurrence is associated with advanced stage and deep myometrial invasion, predominantly affecting older patients with less aggressive tumors.
• Liver/other site recurrence is linked to younger age and poorly differentiated tumors, indicating distinct patterns of hematogenous spread.