The significance of adnexal involvement in endometrial carcinoma

Objective. To evaluate the prognostic significance of and predictive factor s for adnexal involvement (AI) in patients with endometrial carcinoma. Methods. We retrospectively reviewed the pathological features and outcomes of endometrial carcinoma patients. The prognostic significance of AI was e xamined by univariate and multivariate analyses. Median follow-up was 30.7 months. Results. Of the 382 cases reviewed, 40 (10.5%) had AI. Patients with AI had a worse 5-year disease-free (DFS) survival (73.1 vs 37.1%, P < 0.0001) tha n patients without AI, However, patients with AI had multiple adverse featu res, including high grade disease, lymphovascular invasion, and additional sites of extrauterine disease. After controlling for these factors on multi variate analysis, AI lost its prognostic significance (P = 0.56). The 12 AI patients without other extrauterine disease had a favorable outcome (5-yea r DFS of 70.9%), Factors predictive of AI on logistic regression were metas tatic disease, positive peritoneal washings, cervical involvement, and unfa vorable histology, Conclusion. Endometrial carcinoma patients with AI have relatively poor pro gnoses. However, AI per se has little, if any, independent prognostic signi ficance. The poor outcomes seen in these patients appear to result from the preponderance of other adverse pathologic factors, (C) 1999 academic Press .