Significance of lower uterine segment involvement in women with stage I endometrial adenocarcinoma.
OBJECTIVE
To determine whether lower uterine segment involvement (LUSI) correlates with recurrence and survival in women with stage I endometrial adenocarcinoma who do not receive postoperative radiotherapy on the basis of this histologic criterion.


METHODS
Eighty patients with endometrial adenocarcinoma stage I who underwent surgery between 1989 and 2002 were divided into 2 groups according to the presence of LUSI. Group 1 consisted of 25 patients with LUSI; group 2 consisted of 55 patients without LUSI. The 2 groups were compared with regard to prognostic factors and outcome measures.


RESULTS
There were no statistically significant differences between the 2 groups with regard to the following parameters: age and proportion of patients who underwent complete surgical staging and postoperative adjuvant radiotherapy. Pathologic parameters of the 2 groups, such as histologic type, grade and deep myometrial invasion, were comparable. A greater proportion of patients with LUSI had capillary space-like involvement. The patients were followed for a median of 48 months (range, 11-168) from the date of surgery. The overall 5-year recurrence-free survival, disease-specific survival and overall survival rates were 91% (SE .04), 94% (SE .03) and 77% (SE .06), respectively. There was no significant difference between the two groups with regards to these measures (P < .05).


CONCLUSIONS
In patients with state I endometrial cancer, the presence of lower uterine segment involvement does not correlate with their outcome.
Gemer
Ofer
O
Department of Obstetrics and Gynecology, Pathology Institute, Barzilai Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel gemer@barzi.health.gov.il
Uriev
Leonid
L
Harkovsky
Tatiana
T
Peled
Ronit
R
Ben-Dor
David
D
Barak
Frida
F
Segal
Shmuel
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000601:surgery; D002584:Cervix Uteri / Q000473:pathology*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007557:Israel; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D015203:Reproducibility of Results; D016019:Survival Analysis; D013997:Time Factors