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The potential effects of breast cancer (BC) on health-related quality of life (HRQoL) should be considered in clinical and policy decision-making, as the economic burden of BC management is currently assessed. In the last decades, time-to-HRQoL score deterioration (TTD) has been proposed as an approach to the analysis of longitudinal HRQoL in oncology. The main objectives of the current study were to investigate the evolution of the utility values in BC patients after diagnosis and during follow-ups and to evaluate the TTD in utility values among women in all stages of BC.Health-state utility values (HSUV) were assessed using the EuroQol 5-Dimension 3-Level at diagnosis, at the end of the first hospitalization and 3 and 6 months after the first hospitalization. For a given baseline score, HSUV was considered to have deteriorated if this score decreased by ≥ 0.08 points of the EQ-5D utility index score and ≥ 7 points of the EQ visual analogue scale. TTD curves were calculated using the Kaplan-Meier estimation method.Overall 381 patients were enrolled between February 2006 and February 2008. The highest proportions of respondents at the baseline and all follow-ups reporting some and extreme problems were in pain discomfort and anxiety/depression dimensions; more than 80% of patients experienced a deterioration in EQ-5D utility index score and EQ VAS score with a median TTD of 3.15 months and 6.24 Months, respectively.BC patients undergoing therapy need psychological support to cope with their discomfort, pain, depression, anxiety, and fear during the process of diagnosis and treatment to improve their QoL.

To develop a risk scoring system (RSS) to determine recurrence in women with early-stage type 1 endometrial cancer (EC). Data of 396 women with early-stage type 1 EC who received primary surgical treatment between January 2001 and December 2012 were abstracted from multicentre database (training set). A risk model for predicting recurrence was developed and internally validated with the bootstrap technique. The RSS was externally validated using data from an independent population. Overall, the recurrence rate was 12.1 %. The median follow-up and initial time to recurrence were 34 (range 1–152) and 26 (range 1–151) months, respectively. Recurrence was associated with five variables: age ≥60 years, histological grade III, primary tumor diameter >2 cm, depth of myometrial invasion ≥50 %, and the positive lymphovascular space involvement status. These variables were included in the RSS and assigned scores. A total score of 6.5 points corresponded to the optimal threshold of the RSS. For women with a score

The prediction of recurrence after primary surgical treatment in women with cancer is a cornerstone of patient management. In particular, predicting individualised outcome is of major importance for physicians to decide on the treatment options, which follow-up strategies to adopt and how to best counsel the patient. In the field of endometrial cancer (EC), a major cause of morbidity and mortality for women worldwide, most women are diagnosed at an early stage with uterine-confined tumours (Ferlay et al, 2010). However, despite the overall favourable prognosis, some women have aggressive tumours with a substantial risk of recurrence and death (Creasman et al, 1987). The past decade has been marked by several important advances in therapeutic options, such as less morbid surgical approaches and the routine use of chemotherapy and radiotherapy (Karolewski et al, 2006; Colombo et al, 2011). More recently, as for most cancer types, a complementary approach based on prediction models has been developed (Kattan, 2008; Abu-Rustum et al, 2010; Koskas et al, 2011; Bendifallah et al, 2012). Cancer researchers, clinicians and patients are increasingly interested in nomograms, which are defined as a graphical representation of a statistical model to predict a particular end point according to the individual characteristics of the patient (Chun et al, 2006; Bendifallah et al, 2012; Isariyawongse and Kattan, 2012). By providing predictions that are both evidence-based and individualised, these tools can improve medical management and guide the decision-making process (Chun et al, 2006). Kondalsamy-Chennakesavan et al (2012) presented two postoperative nomograms in women with surgically treated stage I–III EC that predict the probability of isolated loco-regional recurrence (ILRR) and distant recurrence (DR) at 3 years. These nomograms are built on clinicopathological parameters and were internally validated using cross-validation and bootstrapping methods. The nomograms included the following covariates: age at diagnosis, FIGO stage (2009), grade, lymphovascular invasion, histological type, depth of myometrial invasion and peritoneal cytology. However, external validation in an independent set of women is required to ensure applicability to patients from different institutions (Awtrey, 2012). The aim of this study was to externally validate these recently introduced nomograms in a population of women with EC using large databases of academic cancer centres.

Endometrial carcinoma is the most common gynecological malignancy. Several molecular biological characteristics have been studied for their potential value in patient management. Our objectives were to compare p53 immunohistochemical expression with P53 gene status determined by fluorescence in situ hybridization (FISH) and to compare these characteristics with ploidy and with classical clinical and histological prognostic factors. We reviewed stored specimens from 43 patients with endometrial cancer diagnosed in 1999–2004. P53 FISH and immunohistochemistry were performed, together with imaging cytometry to calculate DNA ploidy. Thirteen of the 43 endometrial carcinomas (30.2%) showed P53 loss of heterozygosity (LOH). P53 LOH correlated with the histological type (P = .03) and the histological grade (P = .004). Quantitative immunohistochemical expression of p53 protein correlated with the histological type (P = .0001). With a cutoff of 10% of p53-positive cells, p53 overexpression correlated with the histological type (P = .003) and grade (P = .0008). No relation was found between P53 LOH or immunohistochemical expression and the disease stage, the depth of myometrial invasion, lymph node status, lymphovascular space involvement, recurrence, or death from cancer. Nondiploid carcinomas showed deeper myometrial invasion than diploid carcinomas (P = .01). No relation was observed between ploidy and qualitative or semiquantitative p53 expression or P53 LOH. In endometrial cancer, FISH analysis of P53 status adds no significant prognostic information compared with immunohistochemical p53 analysis.