Predictors of recurrence in surgical stage II endometrial adenocarcinoma

Objective. A retrospective review of surgical stage II endometrial carcinom a was performed to evaluate clinical course, treatment, recurrence rate, an d survival. Methods, A list of patients with clinical and surgical stage II endometrial carcinoma was obtained through the tumor registry and from the pathology d epartment from 1988 to 1996. Data were collected on all cases of patients w ith endometrial carcinoma meeting stage II criteria by FIGO surgical stagin g, Variables including stage, histology, grade, lymph vascular space invasi on (LVI), type and extent of surgery, radiation type and amount, smoking, m enstrual status, parity, and age were evaluated for their predictive abilit y of disease recurrence. Cox proportional hazard regression models were use d to examine the potential predictors of time to relapse univariately and m ultivariately. Results. Of patients identified, 65 underwent primary surgical staging. Onl y adenocarcinomas were included. Mean follow-up time was 4.7 years (range 0 .2-9.6 years), Postoperative radiation was given to 85.7% of patients. Ther e were 10 patients (15.4%) with recurrence of disease with a mean time to r ecurrence of 25 months. Five-year disease-specific survival was 93%, The on ly significant predictor of time to relapse was LVI (P = 0.002) in the mult ivariate analysis, Conclusion. This retrospective review suggests that primary surgery followe d by postoperative radiation therapy gives excellent results in surgical st age II disease, LVI appears to be a strong predictor of disease recurrence regardless of postoperative radiation therapy. It is difficult to draw conc lusions about the type and amount of radiation given because recurrence rat e is so low; however, it is reasonable to continue adjuvant radiation espec ially in cases where LVI is identified. (C) 1999 Academic Press.