Cervical stromal involvement can predict survival in advanced endometrial carcinoma: a review of 67 patients

Abstract

Purpose: To assess clinical, surgical and pathologic variables in survival of advanced endometrial cancer.

Methods: Sixty-seven advanced-stage (stages III and IV according to FIGO 2009) endometrial cancer cases were evaluated retrospectively. The effects on survival of age, histologic subtype, stage, grade, myometrial invasion, optimal cytoreduction, parity and cervical involvement were analyzed.

Results: Cervical involvement (P = 0.033) and nulliparity (P = 0.042) were worsening features in terms of survival. In 56 cases (83.5%) optimal cytoreduction could be achieved and survival was significantly longer in this group than the group who were not optimally cytoreduced (mean 30.4 vs. 9.6 months) (P < 0.01). Depth of myometrial invasion, histologic type of tumor, stage, grade, and age younger or older than 60 years were not found to be related to survival. Neither adjuvant therapy type nor their combination were superior to each other for improving survival.

Conclusions: Cervical stromal involvement is a poor prognostic factor in cases of advanced endometrial carcinoma. Further studies are required to describe the effect of different surgical approaches such as radical hysterectomy on survival in the presence of cervical stromal invasion.