Survival outcomes of women with grade 3 endometrioid endometrial cancer: the impact of adjuvant treatment strategies
Citation
Gungorduk K, Muallem J, Aşıcıoğlu O, Gülseren V, Güleç ÜK, Meydanlı MM, Sehouli J, Özdemir A, Şahin H, Khatib G, Miranda A, Boran N, Şenol T, Yıldırım N, Turan T, Oge T, Taşkın S, Vardar MA, Ayhan A, Muallem MZ. Survival outcomes of women with grade 3 endometrioid endometrial cancer: the impact of adjuvant treatment strategies. Arch Gynecol Obstet. 2021 Aug 27. doi: 10.1007/s00404-021-06187-4. Epub ahead of print. PMID: 34448946.Abstract
Aim: This multicenter investigation was performed to evaluate the adjuvant treatment options, prognostic factors, and patterns of recurrence in patients with grade 3 endometrioid endometrial cancer (G3-EEC).
Materials and methods: The medical reports of patients undergoing at least total hysterectomy and salpingo-oophorectomy for G3-EEC between 1996 and 2018 at 11 gynecological oncology centers were analyzed. Optimal surgery was defined as removal of all disease except for residual nodules with a maximum diameter ≤ 1 cm, as determined at completion of the primary operation. Adequate systematic lymphadenectomy was defined as the removal of at least 15 pelvic and at least 5 paraaortic LNs.
Results: The study population consists of 465 women with G3-EEC. The 5-year disease-free survival (DFS) and overall survival (OS) rates of the entire cohort are 50.3% and 57.6%, respectively. Adequate systematic lymphadenectomy was achieved in 429 (92.2%) patients. Optimal surgery was achieved in 135 (75.0%) patients in advanced stage. Inadequate lymphadenectomy (DFS; HR 3.4, 95% CI 3.0-5.6; P = 0.016-OS; HR 3.2, 95% CI 1.6-6.5; P = 0.019) was independent prognostic factors for 5-year DFS and OS.
Conclusion: Inadequate lymphadenectomy and LVSI were independent prognostic factors for worse DFS and OS in women with stage I-II G3-EEC. Adequate lymphadenectomy and optimal surgery were independent prognostic factors for better DFS and OS in women with stage III-IV G3-EEC.
