title: Analysis of prognostic factors and patterns of recurrence in patients with pathologic stage III endometrial cancer.
abstract: OBJECTIVE
  To retrospectively assess prognostic factors and patterns of recurrence in patients with pathologic Stage III endometrial cancer.
  
  
  METHODS
  Between 1989 and 2003, 107 patients with pathologic International Federation of Gynecology and Obstetrics Stage III endometrial adenocarcinoma confined to the pelvis were treated at our institution. Adjuvant radiotherapy (RT) was delivered to 68 patients (64%). The influence of multiple patient- and treatment-related factors on pelvic and distant control and overall survival (OS) was evaluated.
  
  
  RESULTS
  Median follow-up for patients at risk was 41 months. Five-year actuarial OS was significantly improved in patients treated with adjuvant RT (68%) compared with those with resection alone (50%; p = 0.029). Age, histology, grade, uterine serosal invasion, adnexal involvement, number of extrauterine sites, and treatment with adjuvant RT predicted for improved survival in univariate analysis. Multivariate analysis revealed that grade, uterine serosal invasion, and treatment with adjuvant RT were independent predictors of survival. Five-year actuarial pelvic control was improved significantly with the delivery of adjuvant RT (74% vs. 49%; p = 0.011). Depth of myometrial invasion and treatment with adjuvant RT were independent predictors of pelvic control in multivariate analysis.
  
  
  CONCLUSIONS
  Multiple prognostic factors predicting for the outcome of pathologic Stage III endometrial cancer patients were identified in this analysis. In particular, delivery of adjuvant RT seems to be a significant independent predictor for improved survival and pelvic control, suggesting that pelvic RT should be routinely considered in the management of these patients.
authors.affiliation: Division of Radiation Oncology, Department of Oncology, McGill University, Montreal, Quebec, Canada.
authors.forename: Samir
authors.initials: S
authors.lastname: Patel
authors.forename: Lorraine
authors.initials: L
authors.lastname: Portelance
authors.forename: Lucy
authors.initials: L
authors.lastname: Gilbert
authors.forename: Leonard
authors.initials: L
authors.lastname: Tan
authors.forename: Gerald
authors.initials: G
authors.lastname: Stanimir
authors.forename: Marie
authors.initials: M
authors.lastname: Duclos
authors.forename: Luis
authors.initials: L
authors.lastname: Souhami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D011832:Radiation Injuries / Q000150:complications; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D017211:Treatment Failure