title: The significance of adnexal involvement in endometrial carcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic significance of and predictive factors for adnexal involvement (AI) in patients with endometrial carcinoma.
  
  
  METHODS
  We retrospectively reviewed the pathological features and outcomes of endometrial carcinoma patients. The prognostic significance of AI was examined by univariate and multivariate analyses. Median follow-up was 30.7 months.
  
  
  RESULTS
  Of the 382 cases reviewed, 40 (10.5%) had AI. Patients with AI had a worse 5-year disease-free (DFS) survival (73.1 vs 37.1%, P < 0.0001) than patients without AI. However, patients with AI had multiple adverse features, including high grade disease, lymphovascular invasion, and additional sites of extrauterine disease. After controlling for these factors on multivariate analysis, AI lost its prognostic significance (P = 0.56). The 12 AI patients without other extrauterine disease had a favorable outcome (5-year DFS of 70.9%). Factors predictive of AI on logistic regression were metastatic disease, positive peritoneal washings, cervical involvement, and unfavorable histology.
  
  
  CONCLUSIONS
  Endometrial carcinoma patients with AI have relatively poor prognoses. However, AI per se has little, if any, independent prognostic significance. The poor outcomes seen in these patients appear to result from the preponderance of other adverse pathologic factors.
authors.affiliation: Section of Gynecologic Oncology, University of Chicago Hospitals, Chicago, Illinois 60637, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Connell
authors.forename: J
authors.initials: J
authors.lastname: Rotmensch
authors.forename: S
authors.initials: S
authors.lastname: Waggoner
authors.forename: A J
authors.initials: AJ
authors.lastname: Mundt
mesh_terms: D000290:Adnexa Uteri; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies