Various Clinicopathological Factors Impacting Recurrence in Stage I Endometrial Cancer: A Retrospective Study

Abstract

Endometrial cancer usually has a good prognosis. The recurrence and survival in endometrial cancer are based on multiple prognostic factors like patient age, histological grade, myometrial invasion, and lymphovascular space invasion. We investigated various clinicopathological features determining tumor recurrence in stage I endometrial cancer with endometrioid histology. We retrospectively reviewed stage I endometrial cancer patients who underwent surgery at the Basavatarakam Indo American Cancer Hospital between 2010 and 2015. Patients who had tumor recurrence were documented. Various risk factors like size, grade, depth, lymphovascular involvement, etc., were studied, their relation with recurrence was noted, and statistical analysis was done. Twenty-three patients exhibited tumor recurrence in stage I EEC (13.3%). When considering the depth of myometrial invasion, the 5-year RFS of stage IA EEC is 90.4% in comparison with 66.6% when the depth of invasion is more than half of myometrial invasion. The 5-year RFS of the patients with stage I EEC is 100% in tumors with size less than 2 cms, 92.15% in tumor size 2–4 cms, and 70.45% when the tumor size is greater than 4 cms. The 5-year RFS of the patients is 94.7% in grade 1, 87.3% in grade 2, and 54.2% in grade 3. Depth of myometrial invasion, grade, and size of the primary tumor are shown to affect recurrence. LUS involvement, intracervical glandular involvement, and the lymphovascular space invasion did not affect recurrence in endometrioid endometrial cancer.