REASSESSMENT OF MYOMETRIAL INVASION IN ENDOMETRIAL CARCINOMA

Objective: To assess different methods of measuring the depth of myome trial invasion in endometrial carcinoma as a prognostic factor. Method s: Eighty-eight cases of stage I or II endometrial carcinoma treated i nitially by hysterectomy between 1979-1989 were reviewed histologicall y. Three methods of measuring myometrial invasion were evaluated: 1) p ercentage of invaded tumor thickness to whole thickness of myometrium, 2) percentage of whole tumor thickness to total thickness of tumor an d myometrium, and 3) distance from the tumor-myometrial junction to th e uterine serosa. We evaluated the effect of several factors on progno sis by multivariate analysis using Cox regression models. Results: Myo metrial invasion determined by these three measurement methods was ass ociated significantly with survival in a univariate analysis. When myo metrial invasion assessed by each method and other prognostic factors were entered into a multivariate model, the distance from the tumor-my ometrial junction to the uterine serosa, lymphvascular space invasion, and cervical stromal involvement were identified as independently sig nificant prognostic factors. Conclusion: This method of evaluating myo metrial invasion by measuring the distance from the tumor-myometrial j unction to the uterine serosa was most useful as a correlate with surv ival.