Stage 3B adenocarcinoma of the endometrium: A clinicopathologic study

Objective. The aims of this study were to evaluate the management of Stage IIIB adenocarcinoma of the endometrium (EAC) and to determine the utility o f the FIGO classification as it applies to patients with this category of d isease and make recommendations on management. Methods. A retrospective review was undertaken of the database of the Queen sland Centre for Gynaecological Cancer (QCGC) from January 1982 to December 1996. The records of all patients recorded as having Stage IIIB EAC were r etrieved. After validation of the designated staging, the contemporary dise ase status was determined and clinicopathological details were extracted fr om case notes. Results. Of a total of 1940 patients with EAC treated by QCGC over the 15-y ear study period, 14 (0.7%) patients met the inclusion criteria. Nine patie nts (64%) presented with postmenopausal bleeding and the remaining patients presented with a variety of symptoms. There was no statistically significa nt difference in age between the study group and other patients with advanc ed stage EAC ranging from Stage IIIA to Stage IVB disease. Survival of pati ents with Stage IIIB disease was statistically significantly worse than tha t of patients with Stage IIIA disease, but was not statistically significan tly different from patients with Stage IIIC, IVA, or IVB. While all patient s had the unifying characteristic of metastatic disease in the vagina, the true extent of disease could not be determined by a full surgical staging p rocedure. Such optimal surgery was contraindicated in all patients because of the presence of significant coexisting medical conditions. Consequently, treatment was highly individualized. Conclusions. Stage IIIB adenocarcinoma of the endometrium is an uncommon co ndition, Similar to other substages of advanced disease, it is associated w ith a poor prognosis and requires individualized management. The argument i s presented that this substage could be eliminated and included with Stage IIIC disease. (C) 2000 Academic Press.