Prognostic Analysis and Influencing Factors of Postoperative Synchronous Chemoradiotherapy for Endometrial Cancer

XU Lingyun; CHEN Juanjuan; HUO Zhenzhen

doi:10.3969/j.issn.1004-437X.2025.16.017

Abstract：Objective To analyze the factors affecting the prognosis of endometrial cancer(EC)patients undergoing synchronous chemoradiotherapy after surgery,and to construct a prognostic model.Methods A total of 310 EC patients admitted to Kaifeng Maternal and Child Health Hospital from March 2019 to January 2022 were selected.All patients underwent surgical treatment and received synchronous chemoradiotherapy after surgery.After a 2-year follow-up,303 cases were successfully completed.Patients were categorized into good prognosis group and poor prognosis group according to their prognosis.The factors affecting the poor prognosis of EC patients undergoing synchronous chemoradiotherapy were analyzed using single factor and LASSO-logistic regression analysis.A nomogram model was constructed and its efficacy in predicting poor prognosis in patients with EC who underwent postoperative synchronous chemoradiotherapy was evaluated.Results Of the 303 patients with EC,83 cases(27.39％)had a poor prognosis,while 220 cases(72.61％)had good prognosis.Comparison of the degree of pathological differentiation,maximum diameter of the lesion,Federation International of Gynecology and Obstetrics(FIGO)staging,myxoid infiltration,consolidation chemotherapy,preoperative serum carbohydrate antigen 125(CA125),lymphovascular interstitial invasion,human epididymal secretory protein 4(HE4),lower uterine segmental involvement,and meconium chitinase protein 40(YKL-40)between two groups,all differences were statistically significant(P＜0.05).LASSO regression screened eight characteristic variables as degree of pathologic differentiation,mylohyoid infiltration,FIGO stage,lymphovascular space invasion,consolidation chemotherapy,preoperative serum CA125,HE4,and YKL-40.Mylohyoid infiltration,degree of pathologic differentiation,FIGO stage,lymphovascular space invasion,consolidation chemotherapy,preoperative serum CA125,HE4,and YKL-40 were all EC patient prognostic factors for postoperative concurrent radiotherapy(P＜0.05).The nomogram prediction model was constructed based on the influencing factors obtained from LASSO-logistic regression,the receiver operating characteristic(ROC)curve and calibration curve showed that the model had good discrimination and consistency.Conclusion The factors influencing the prognosis of after synchronous chemoradiotherapy for EC were mylohyoid infiltration,degree of pathological differentiation,FIGO stage,lymphovascular interstitial invasion,consolidation chemotherapy,and preoperative serum CA125,HE4,and YKL-40,and the predictive prognostic model constructed accordingly predicted a good efficacy.