Outcome of Endometrial Cancer Stage IIIA with Adnexa or Serosal Involvement Only

Jan J Jobsen,Astrid Scholten,Marika C Stenfert Kroese,Marnix L M Lybeert,Lambert Naudin Ten Cate,Annerie Slot,Sabine Siesling,Elzbieta M Van Der Steen-Banasik,Job Van Der Palen,Eltjo M J Schutter

doi:10.1155/2011/962518

Abstract

Objective. The aim of this study is to look at possible differences in outcome between serosa and adnexal involvement stage IIIA endometrial carcinoma. Methods. 67 patients with stage IIIA endometrial carcinoma were included, 46 with adnexal involvement and 21 with serosa. A central histopathological review was performed. Results. The 7-year locoregional failure rate was (LRFR) 2.2% for adnexal involvement and 16.0% for involvement of the serosa (P = .0522). The 7-year distant metastasis-free survival was 72.7% for adnexal involvement and 58.7% for serosa (P = .3994). The 7-year disease-specific survival (DSS) was 71.8% for patients with adnexal involvement and 75.4% for patients with serosa. Conclusion. Endometrial carcinoma stage IIIA with involvement of the adnexa or serosa showed to have a comparable disease-specific survival. Locoregional control was worse for serosa involvement compared to adnexa.

Highlights

The majority of patients with endometrial cancer are diagnosed without evidence of extra uterine spread, leading to only 10–15% of the patients with stage III disease [1]
In 1988, the International Federation of Gynecology and Obstetrics (FIGO) mandated the staging of endometrial cancer be changed from a clinical staging system to a surgical staging system because of the inaccuracies of the former
Our study showed that patients with stage IIIA endometrial carcinoma with involvement of adnexa or the serosa had comparable disease-specific survival of 71.8% and 75.4% at 7 years, respectively

Summary

Introduction

The majority of patients with endometrial cancer are diagnosed without evidence of extra uterine spread, leading to only 10–15% of the patients with stage III disease [1]. According to FIGO 1997 stage IIIA endometrial carcinoma is defined as tumor involvement either as direct extension or metastasis to serosa, parametria, adnexa, and/or cancer cells in peritoneal washings [2]. Due to this broad definition, patients with stage IIIA form a heterogeneous group. FIGO has recently updated the staging system with a significant change to the staging of Obstetrics and Gynecology International endometrial carcinoma stage IIIA. The presence of abnormal cells in peritoneal washings no longer affects staging This resulted in a less heterogeneous stage IIIA

Methods

Results

Discussion

Conclusion