Stage III endometrial cancer: preoperative predictability, prognostic factors, and treatment outcome.
OBJECTIVE
The survival rate for the most common gynecologic cancer, endometrial cancer, has fallen significantly in the last 25 years. Stage III (International Federation of Gynecology and Obstetrics) disease accounts for most of the deaths. We evaluated prognostic factors, treatment-related survival, and routinely used assessments for identifying stage III disease before the operation.


METHODS
The data for patients with endometrial cancer stage III (n = 101) who had been treated at the McGill University Health Center between 1989 and 2003 were analyzed.


RESULTS
Stage IIIA, IIIB, and IIIC tumors accounted for 63%, 4%, and 33% of the data, respectively. The cause-specific survival at 2, 3, and 5 years was 82%, 77%, and 67%, respectively. In multivariate analysis with an adjustment for the standard prognostic variables, the final tumor grade, adnexal involvement, and lymph node dissection were significant predictors of cause-specific survival (P = .001, .028, and .017, respectively). Of the preoperative investigations, an elevated CA-125 level was a significant predictor of cause-specific survival in multivariate analysis (P = .029).


CONCLUSIONS
An elevated CA-125 level, adnexal involvement, the final tumor grade, and lymph node dissection were independent predictors for cause-specific survival.
Denschlag
Dominik
D
Division of Gynecological Oncology, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada.
Tan
Leonard
L
Patel
Samir
S
Kerim-Dikeni
Abbas
A
Souhami
Luis
L
Gilbert
Lucy
L
D000290:Adnexa Uteri / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000097:blood; D002170:Canada / Q000453:epidemiology; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D018293:Cystadenoma, Serous / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D019290:Megestrol Acetate / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010052:Ovariectomy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012042:Registries
D018931:Antineoplastic Agents, Hormonal; D018394:CA-125 Antigen; D019290:Megestrol Acetate