[Combined treatment and prognostic factors for stage III and IV endometrial carcinoma].
OBJECTIVE
To evaluate prognostic factors and treatment of patients with advanced stage endometrial cancer.


METHODS
One hundred and eighteen patients with advanced stage endometrial cancer were treated in our hospital between January 1996 and December 2006. The treatment and prognosis were retrospectively analyzed. The mean follow-up time was 26 months.


RESULTS
During the follow-up, 33 cases (28.0%) died and 25 patients (21.2%) had disease progression. The 3-year overall survival for patients with stage III and stage IV was 78.3% and 39.4%, and for endometrioid and nonendometrioid endometrial carcinoma was 69.3% and 42.0%, respectively. Four patients with positive cytology only were followed closely after surgery and were free of disease up to the report time. Patients with late stages, deep myometrial invasion, nonendometrioid endometrial cancer, poor differentiation, without lymphadenectomy and without radiochemotherapy after surgery were associated with a worse prognosis by univariate analysis (P < 0.05), while in a multivariate analysis only late stages and deep myometrial invasion were associated with a poor prognosis (P < 0.05). The patients who received lymphadenectomy and whose residual disease after the surgery was less than 1 cm had better prognoses than those otherwise (P < 0.05). The patients who received postoperative radiochemotherapy had better prognoses than those who did not (P < 0.05).


CONCLUSIONS
Pathological stage and myometrial invasion are independent prognostic factors for late stage endometrial cancer. Satisfactory cytoreduction surgery and lymphadenectomy, followed by postoperative radiochemotherapy, except for stage IIIa patients with positive cytology only, are recommended in order to improve prognosis.
Ren
Yu-lan
YL
Department of Gynecological Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Wang
Hua-ying
HY
Shi
Da-ren
DR
Yang
Wen-tao
WT
Sun
Zhi
Z
Chen
Yun
Y
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome