Prognostic factors in patients treated with taxane-based chemotherapy for recurrent or metastatic endometrial cancer: proposal for a new prognostic model.

摘要

OBJECTIVE: Taxane-based chemotherapy has been recently introduced as an effective therapeutic option in recurrent or metastatic endometrial carcinoma (RMEC). The aim of the study was to determine the prognostic factors in RMEC after taxane-based chemotherapy. METHODS: One hundred ten patients who received paclitaxel-containing regimen for RMEC were retrospectively evaluated. Potential prognostic factors for overall survival were identified with the Kaplan-Meier method in univariate and the Cox regression model in multivariate analysis. RESULTS: Performance status (PS) and relapse within the field of previous external radiation were independent prognostic factors for overall survival (p=0.007 and p=0.026 respectively). Non-endometriod histology was associated with a shorter median survival compared to endometriod adenocarcinoma (14.46 vs. 17.57 months, p=0.093), but histology was not an independent prognostic factor (HR=1.43, 95% CI: 0.82-2.48, p=0.21). Stratification according to PS and relapse within the irradiation field identified three risk groups with distinctly different prognosis (median survival 27.36, 16.71, and 11.33 months for the group of favorable, intermediate, and unfavorable prognosis respectively, p<0.001). Within the favorable prognosis group, 34% of patients had a probability of 5-year survival. CONCLUSION: PS at diagnosis and relapse within the irradiated area may constitute a valid prognostic model in RMEC patients who receive taxane-based chemotherapy and are able to identify long-term survivors.