Surgical Outcomes and Patterns of Recurrence in Endometrial Cancers

Abstract

Abstract

Objectives:

There were two objectives: (1) to assess the survival outcome of endometrial cancer based on surgical and adjuvant treatment and (2) to note patterns of and risk factors for recurrence in endometrial cancer.

Design:

This was a retrospective analysis of the hospital records of women diagnosed with carcinoma of the endometrium who were operated on in the Division of Gynecologic Oncology, Christian Medical College, Vellore, India, from January 2011 to December 2013.

Materials and Methods:

Electronic patient records of 152 women with endometrioid endometrial cancer were obtained and used to analyze their surgical outcomes. Information regarding survival and recurrences was obtained by various methods. Survival was assessed by Kaplan–Meir survival analysis.

Results:

The tumors were endometrioid adenocarcinomas in 94.7% of the patients. The majority of the patients were stage IA (49.3%) and stage IB (22.3%). A few patients also had occult stage II (6.6%), and 21% had advanced stage cancer. Seventy-seven (50.7%) women needed adjuvant treatment after risk stratification, with 53.6% receiving radiation only as brachytherapy (35.6%), external pelvic radiation (13.5%), or a combination of both (50.9%); 15.9% received chemotherapy; and 30.4% had radiation and chemotherapy. The 3-year survival of endometrial cancers was 94.5% and disease-free survival was 91.4%. The rate for recurrence was 8.6% and for mortality 5.5%. Recurrences were equal in distribution for local and distant metastasis. Complications of surgical treatment were minimal.

Conclusions:

Endometrial cancers tend to present as early stage cancers in the majority of cases. Appropriate risk stratification and liberal use of chemotherapy when indicated may improve survival in high-risk cases. (J GYNECOL SURG 2017:1)