Prognostic factors and selective use of vaginal hysterectomy in early stage endometrial carcinoma

Introduction. Endometrial cancer represents the fourth most frequent malign ancy in women of any age, tending to become the most common gynaecological tumor in developed Countries. A retrospective analysis has been conducted o n the prognostic factors of endometrial neoplasm during 15-years experience (1977-1991). Material and Methods. 321 patients affected by stage I and II endometrial c arcinoma have been treated surgically first hand. Surgical-pathological sta ging and prognostic factors were reviewed and related to follow-up and 5-ye ar survival rate. Results. The age-peak of patients was 50-70 years; prevalent histologic typ e was adenocarcinoma (95.6%); 269 patients were in stage I and 52 in stage II. In stage I disease overall 5-year survival rate resulted to be 81.4%, w hile in stage TI it fell to 59.6%. Discussion. Myometrial involvement by adenocarcinomatous cells is probably the most important prognostic factor, considering its reliability and non-c ontradictory evaluation. Our data confirm. there is no difference in impact on 5-year survival between abdominal and vaginal routes in clinical stage I and occult stage Il endometrial carcinoma.