{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T08:20:10Z","timestamp":1759566010081},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,7,17]],"date-time":"2012-07-17T00:00:00Z","timestamp":1342483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Chattopadhyay S, Galaal K, Patel A, Fisher A, Nayar A, Cross P, Naik R. Tumour\u2010free distance from serosa is a better prognostic indicator than depth of invasion and percentage myometrial invasion in endometrioid endometrial cancer. BJOG 2012;119:1162\u20131170.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To evaluate the prognostic performance of tumour\u2010free distance (TFD) compared with depth of invasion (DOI) and percentage of myometrial invasion (MI).<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Retrospective cohort study.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Regional gynaecological oncology centre.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> All women identified with stage I\u2013III endometrioid endometrial carcinoma from January 2000 to December 2007, who had surgery at the Northern Gynaecological Oncology Centre (NGOC).<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Surgicopathological, follow\u2010up and survival data were collected. Univariate and multivariate analyses were performed comparing TFD, DOI and MI with known prognostic factors. The prognostic accuracy of TFD was assessed by receiver operating characteristic (ROC) curve analyses, and an optimum cut\u2010off was proposed.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Death from disease, recurrence and pelvic lymph node involvement.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> A total of 288 women were identified. The median follow\u2010up time was 67\u2003months, with 40 recurrences and 32 disease\u2010related deaths. When TFD, DOI and MI were separately examined in multivariate analyses with other covariates, TFD was an independent predictor of death from disease (HR\u20031.22; 95%\u2003CI\u20031.00\u20131.48; <jats:italic>P\u2003<\/jats:italic>=\u20030.05). In multivariate analyses including all three measures together (TFD, DOI and MI), TFD was an independent predictor of death from disease (HR\u20031.49; 95%\u2003CI\u20031.03\u20132.16; <jats:italic>P\u2003<\/jats:italic>=\u20030.04) and recurrence (HR\u20031.39; 95%\u2003CI\u20031.01\u20131.91; <jats:italic>P\u2003<\/jats:italic>=\u20030.05). TFD was also an independent predictor of lymph node involvement when examined separately (OR\u20030.74; 95%\u2003CI\u20030.56\u20130.96; <jats:italic>P\u2003<\/jats:italic>=\u20030.03), and together with DOI and MI (OR\u20030.67; 95%\u2003CI\u20030.49\u20130.92; <jats:italic>P\u2003<\/jats:italic>=\u20030.01), in women who had pelvic lymphadenectomy (<jats:italic>n<\/jats:italic>\u2003=\u200386). A TFD cut\u2010off of 1.75\u2003mm showed good prognostic performance.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> The TFD measure may be a more accurate method of representing myometrial invasion in the staging for endometrial cancer.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2012.03427.x","type":"journal-article","created":{"date-parts":[[2012,7,19]],"date-time":"2012-07-19T04:07:07Z","timestamp":1342670827000},"page":"1162-1170","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Tumour\u2010free distance from serosa is a better prognostic indicator than depth of invasion and percentage myometrial invasion in endometrioid endometrial cancer"],"prefix":"10.1111","volume":"119","author":[{"given":"S","family":"Chattopadhyay","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KA","family":"Galaal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Nayar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Cross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Naik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,7,17]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960315)77:6<1115::AID-CNCR17>3.0.CO;2-4"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2004.02.007"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00161-5"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2000.6058"},{"key":"e_1_2_10_6_2","volume-title":"Standards and Datasets for Reporting Cancers"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-199801000-00008"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.pgp.0000233165.56385.0b"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2003.08.003"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(78)90008-2"},{"key":"e_1_2_10_11_2","first-page":"825","article-title":"Surgical staging in endometrial cancer: clinical\u2010pathological findings of a prospective study","volume":"63","author":"Boronow RC","year":"1984","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_12_2","first-page":"979","article-title":"Reassessment of myometrial invasion in endometrial carcinoma","volume":"84","author":"Kaku T","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.09.009"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/IGC.0b013e3181ef0a31"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.09.003"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61766-3"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/39.4.561"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533958"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1999.5505"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.06.011"},{"key":"e_1_2_10_21_2","volume-title":"Protocol for the Examination of Specimens from Patients with Carcinoma of the Endometrium"},{"key":"e_1_2_10_22_2","volume-title":"Endometrial Cancer Structured Reporting Protocol","year":"2011"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70275-9"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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