Influence of treatment and tumor grade on the prognosis of stage II carcinoma of the endometrium.
A retrospective analysis of 53 patients with stage II endometrial carcinoma treated between 1963 and 1975 was undertaken to evaluate the efficacy of treatment methods and the effect of tumor grade on survival and failure. Thirty-eight patients were irradiated preoperatively followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy, 15 were followed for at least 5 years with no lost to follow-up. An overall 5-year disease-free survival of 60.6 per cent was obtained. Further analysis of the data showed that tumor grade and treatment method were important factors influencing the prognosis. The data support the improved survival rate when irradiation is followed by hysterectomy. Patients with a low grade tumor (G1) given preoperative irradiation have a better survival than those with high grade tumor (G3) treated by the same method. Failure rate is also dependent on method of treatment and tumor grade. The results are in agreement with several data in the literature that combination of the irradiation and surgery should be the treatment of choice for stage II endometrial carcinoma. Tumor grade is also an important factor and must be evaluated for the extension of the disease before the proper management. For the high grade tumor, para-aortic node sampling might be important for the irradiation and should warrant further investigation.
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy; D014594:Uterine Neoplasms / Q000532:radiotherapy* / Q000601:surgery