Clinical Characteristics and Prognostic Factors of Endometrial Cancer Patients With Liver Metastasis: A Surveillance, Epidemiology, and End Results Database (SEER)-Based Study of 1,034 Women

Abdulhameed Alhadeethi; Ahmed A Ibrahim; Ahmed Atia; Yasmeen J Alabdallat; Ibraheem M Alkhawaldeh; Mostafa H El Din Moawad

doi:10.7759/cureus.54606

Clinical Characteristics and Prognostic Factors of Endometrial Cancer Patients With Liver Metastasis: A Surveillance, Epidemiology, and End Results Database (SEER)-Based Study of 1,034 Women

Cureus. 2024 Feb 21;16(2):e54606. doi: 10.7759/cureus.54606. eCollection 2024 Feb.

Authors

Abdulhameed Alhadeethi¹, Ahmed A Ibrahim², Ahmed Atia³, Yasmeen J Alabdallat⁴, Ibraheem M Alkhawaldeh⁵, Mostafa H El Din Moawad⁶

Affiliations

¹ Department of General Medicine, Al-Salam Teaching Hospital, Mosul, IRQ.
² Cardiology, Faculty of Medicine, Menofia University, Menofia, EGY.
³ Cardiovascular Disease, Kasr Alainy School of Medicine, Cairo University, Cairo, EGY.
⁴ Surgery, Hashemite University, Zarqa, JOR.
⁵ Faculty of Medicine, Mutah University, Alkarak, JOR.
⁶ Clinical Epidemiology and Clinical Trials Management, Public Health and Community Department, Suez Canal University, Ismailia, EGY.

Abstract

Background There are several patterns of metastatic spread from endometrial cancer (EC). Although studies have been conducted to study the EC population with distant metastasis in the bone and lungs, there is still a lack of studies on liver metastasis. This study aims to evaluate and assess the clinical features and prognostic factors of EC patients with liver metastasis. Methodology We conducted a retrospective cohort study adhering to the guidelines for reporting observational research. We utilized the Surveillance, Epidemiology, and End Results database to gather data on female patients diagnosed with EC and reported liver metastasis. We estimated survival curves using the Kaplan-Meier method and evaluated differences in survival using the log-rank test. We also conducted univariable and multivariable Cox proportional hazards regression analyses to determine the hazard ratios with 95% confidence intervals for overall survival (OS) and identify factors that impact survival. Results We analyzed data from 1,034 EC patients with liver metastasis. Median OS after liver metastasis was six months, and cancer-specific survival was seven months. Univariate Cox regression analysis revealed several factors associated with decreased OS in EC patients. These included age (≥60 years), non-endometrioid and sarcoma histological subtypes, absence of surgery, no chemotherapy, and the presence of distant metastasis to the lung, brain, and bone. Conversely, married marital status and white race were linked to a better prognosis. Subsequent multivariate Cox regression analysis identified age (≥60 years), non-endometrioid histological subtype, absence of surgery, no chemotherapy, and the presence of distant metastasis to lung, brain, and bone remaining as independent risk factors for decreased OS. In contrast, the white race still emerged as an independent prognostic factor for better OS. Conclusions Various risk factors, such as age, race, lung, bone, or brain metastasis, as well as chemotherapy and surgery, may influence the prognosis of individuals with primary EC liver metastases.

Keywords: endometrial cancer; liver metastasis; overall survival; seer; tumor.