Évaluation pronostique de la nouvelle classification des groupes de risque dans le cancer de l’endomètre : étude rétrospective monocentrique portant sur 378 patientes

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Introduction: endometrial cancer is a pathology of great complexity, both in patients and in tumors. In order to take into account this heterogeneity, and thus to optimize the adjuvant treatments, classifications in risk groups have been established, according to the prognostic and clinical and histological factors. The interest of molecular factors is growing, especially since the recent work of the Cancer Genome Atlas. The objective of our study was to assess the prognostic relevance of new risk groups delineated by the 2016 ESMO / ESGO / ESTRO consensus conference. Patients and methods: this is a retrospective monocentric study carried out on 378 patients whose cases were discussed in a multidisciplinary consultation meeting at the Institut Bergonié in Bordeaux and who presented endometrial cancer between January 1 2010 and December 31, 2016. Results: univariate analysis showed that grade 3, presence of lymphovascular embolus, lymph node involvement, FIGO stage, the high risk group according to the old ESMO classification and the new one, and the absence of treatment adapted to the recommendations, were risk factors for recurrence (p <0.001). Risk factors in multivariate analysis, these were grade 3 (p = 0.007), FIGO III (p <0.001), and lack of adjuvant therapy (p <0.001). Recurrence-free survival at 4 years was better in the upper intermediate risk group (71.6 %) than in the intermediate risk group. Many patients received adjusted surgery (83.6 %) and adjuvant therapy adapted to their risk group (86.2%). Conclusion: treatments (lymphadenectomy, adjuvant treatments) appear to decrease the prognostic impact of risk groups. An assessment of the side effects of treatments and quality of life is needed. Even combined, the prognostic factors seem currently limited and insufficient to account for the evolutionary and prognostic heterogeneity of this pathology. The interest of molecular factors is growing, especially since the recent work of Cancer Genome Atlas. Future classification will have to integrate a biological component.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.