IMPLICATION OF NEW FIGO SURGICAL STAGING ON PATTERNS OF FAILURE AND SURVIVAL IN ENDOMETRIAL CARCINOMA

Continued emphasis on treating endometrial cancer primarily as a surgi cal disease has led to the institution, in 1988, of a new staging syst em based on operative findings. Since the system is new, limited exper ience has been published confirming its theoretical advantage in predi cting clinical outcome. In a four year period, 117 patients with newly diagnosed endometrial cancer were referred for adjuvant radiation the rapy to the Department of Radiation Oncology. All patients were restag ed based on surgical findings according to the revised 1988 FIGO Stagi ng System. This requires an assessment of peritoneal washings, myometr ial invasion, cervical involvement, adnexal and pelvic/para-aortic lym ph node metastasis. 39 patients were excluded, leaving 78 patients who were distributed in each stage as follows: Stage I-39 pts (IA 2 pts, IB 24 pts, IC 13 pts), Stage II-10 pts (IIA 5 pts, IIB 5 pts), Stage I II-21 pts (IIIA 6 pts, IIIB 1 pt, IIIC 14 pts). and Stage IV-8 pts (IV A 1 pt, IVB 7 pts). The median follow-up time was 40 months, ranging f rom 3-82 months. The three year absolute and disease-free survival in each stage were: Stage I-97% and 97%, Stage II-79% and 80%, Stage III- 37% and 24%, and Stage IV-13% and 0%, respectively. The locoregional a nd distant failure rates were: Stage I-3% and 5%, Stage II-20% and 0%, Stage III-10% and 76%, respectively. This retrospective analysis sugg ests that the survival and distant failure are well predicted by the r evised FIGO Staging System, which relies completely on findings at sur gical staging.