title: Positive adnexal or uterine serosal involvement in stage IIIC endometrial cancer is an adverse factor for recurrence.
abstract: OBJECTIVE
  Clinical and pathological significance of stage IIIC endometrial cancer is unclear. Our study was designed to determine the risk of recurrence among patients with stage IIIC endometrial cancer according to different pathological findings.
  
  
  METHODS
  We retrospectively reviewed all patients with FIGO IIIC endometrial carcinoma (n = 48) treated in our institution between 1996 and 2005. Patients without comprehensive surgical staging were excluded. Patients were classified into two groups: with adnexae and/or uterine serosal metastasis (group A, n = 18) and without metastasis (group B, n = 20). Cox proportional hazards model was used for multiple regression analysis.
  
  
  RESULTS
  Mean age was 64 years (range 46-90). Eighteen patients received adjuvant chemotherapy and pelvic radiotherapy, 17 received pelvic radiotherapy alone, and 11 received chemotherapy or hormonotherapy. At a median follow-up of 26.7 months, 12 had recurrence of the disease. Serosal and/or adnexal involvement was a negative independent prognostic factor for disease-free survival [relative risk = 3.75 (1.01-13.9); p = 0.04], whereas histological type, grade, depth of invasion and age at diagnosis had no influence.
  
  
  CONCLUSIONS
  Patients with stage IIIC endometrial cancer and metastasis to adnexae and/or serosa have a higher risk of recurrence than those with node metastasis alone. Optimal adjuvant therapy for these groups remains unclear.
authors.affiliation: Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Qué., Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Hétu
authors.forename: Patrick
authors.initials: P
authors.lastname: Petignat
authors.forename: Yucan
authors.initials: Y
authors.lastname: Wu
authors.forename: Pierre
authors.initials: P
authors.lastname: Drouin
authors.forename: Philippe
authors.initials: P
authors.lastname: Sauthier
authors.forename: Diane
authors.initials: D
authors.lastname: Provencher
authors.forename: Philippe
authors.initials: P
authors.lastname: Gauthier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000556:secondary*; D010537:Peritoneum / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors