N. Kadar et al., PROGNOSTIC FACTORS IN SURGICAL STAGE-III AND STAGE-IV CARCINOMA OF THE ENDOMETRIUM, Obstetrics and gynecology, 84(6), 1994, pp. 983-986
Objective: To identify prognostic factors in surgical stage III and TV
endometrial carcinoma. Methods: We performed a retrospective analysis
of 58 cases of stage III and IV endometrial cancer using the Cox prop
ortional hazards model. Results: Extrapelvic peritoneal metastases and
positive peritoneal cytology greatly affected survival. If either of
these factors was present, the 2-year survival rate was only 25%, wher
eas if they were absent, it was 82%. All patients with extrapelvic met
astases died of their disease despite systemic therapy, as did ten of
13 patients with positive peritoneal cytology. Although postoperative
therapy in these patients varied, it had no obvious effect on survival
or on the site of recurrence. In the absence of abdominal disease or
positive peritoneal cytology, survival was not influenced significantl
y by the presence or absence of lymph node metastases. The difference
in survival between women with aortic and pelvic lymph node metastases
(24% at 5 years) was not significant, but the power to detect this di
fference was low (35%). Stage affected survival significantly (P < .05
), but a two-category variable, indexing patients as having either pos
itive peritoneal cytology or abdominal disease, provided a much better
fit and a more parsimonious model for the data. Conclusion: Five-year
survival rates exceeding 70% can be achieved in endometrial carcinoma
even if extrauterine disease is present, provided that peritoneal cyt
ology is negative and abdominal metastases are absent.