[Modern tendencies in treatment of endometrial cancer stage III C].
OBJECTIVE
The aim of our research work was to evaluate the potential of treatment in patients with endometrial cancer stage IIIC, with positive enlarged lymph nodes. We tried also to summarize also some other clinical prognostic factors. Our and foreign experience in this field was evaluated.


METHODS
102 patients with endometrial cancer stage IIIC were researched for the period of 1990 till 2008. The data were collected retrospectively. We used the methods of Kaplan-Meier, the logistic regression analysis and proportional regression model of Cox. All patients had enlarged/positive/lymph nodes, and 30 of them had positive paraaortal lymph nodes.


RESULTS
All patients received postoperative radiotherapy. In 30 patients--postoperative paraaortal radiotherapy, and 25 patients was applied postoperative chemotherapy. The median disease specific survival for all patients was 32,5 months. Patients with totally removed/resected/macroscopic enlarged lymph nodes had a significant longer disease specific survival/38,5 months/ in comparison with patients to whom was not performed lymph node dissection/debulking/of the enlarged lymph nodes/9,7 months, p = 0,05/. In multivariation analysis, the independent prognostic factors were: the size of the lymph node, the residual tumour/metastatic lymph nodes/--p < 0,001, the age < 65 years--p = 0,001, and the implementation of adjuvant chemotherapy/p = 0,016/.


CONCLUSIONS
In patients with endometrial cancer stage IIIC, the resection/debulking/ of macroscopic enlarged lymph nodes and the implementation of adjuvant chemotherapy in addition to radiotherapy is connected with better survival rate.
Ivanov
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