Stage III endometrial cancer: preoperative predictability, prognostic factors, and treatment outcome

Am J Obstet Gynecol. 2007 Jun;196(6):546.e1-7. doi: 10.1016/j.ajog.2007.01.018.

Abstract

Objective: The survival rate for the most common gynecologic cancer, endometrial cancer, has fallen significantly in the last 25 years. Stage III (International Federation of Gynecology and Obstetrics) disease accounts for most of the deaths. We evaluated prognostic factors, treatment-related survival, and routinely used assessments for identifying stage III disease before the operation.

Study design: The data for patients with endometrial cancer stage III (n = 101) who had been treated at the McGill University Health Center between 1989 and 2003 were analyzed.

Results: Stage IIIA, IIIB, and IIIC tumors accounted for 63%, 4%, and 33% of the data, respectively. The cause-specific survival at 2, 3, and 5 years was 82%, 77%, and 67%, respectively. In multivariate analysis with an adjustment for the standard prognostic variables, the final tumor grade, adnexal involvement, and lymph node dissection were significant predictors of cause-specific survival (P = .001, .028, and .017, respectively). Of the preoperative investigations, an elevated CA-125 level was a significant predictor of cause-specific survival in multivariate analysis (P = .029).

Conclusion: An elevated CA-125 level, adnexal involvement, the final tumor grade, and lymph node dissection were independent predictors for cause-specific survival.

MeSH terms

  • Adnexa Uteri / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • CA-125 Antigen / blood
  • Canada / epidemiology
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / therapy
  • Chemotherapy, Adjuvant
  • Cystadenoma, Serous / mortality
  • Cystadenoma, Serous / pathology
  • Cystadenoma, Serous / therapy
  • Endometrial Neoplasms / mortality*
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / therapy
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Hysterectomy
  • Lymph Node Excision
  • Megestrol Acetate / therapeutic use
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / epidemiology
  • Ovariectomy
  • Prognosis
  • Radiotherapy, Adjuvant
  • Registries

Substances

  • Antineoplastic Agents, Hormonal
  • CA-125 Antigen
  • Megestrol Acetate