title: A validation study of the new revised FIGO staging system to estimate prognosis for patients with stage IIIC endometrial cancer.
abstract: OBJECTIVE
  The aim of this study was to validate the role of the new FIGO staging system for estimating prognosis for patients with stage IIIC endometrial cancer.
  
  
  METHODS
  A total of 93 cases with stage IIIC were entered in this study and classified into three groups: one group of patients who underwent pelvic lymphadenectomy (PLX) and para-aortic lymphadenectomy (PALX) and who were for positive for pelvic node metastasis (PLNM) and negative for para-aortic node metastasis (PANM) (Group 1), one group of patients who underwent PLX alone and were positive for PLNM (Group 2) and one group of patients who underwent PLX and PALX and were positive for PANM (Group 3). Information on clinicopathologic findings and treatments was obtained from medical charts. Cox regression analysis was used to select prognostic factors.
  
  
  RESULTS
  The 5-years survival rates were 89.3% in Group 1, 46.5% in Group 2 and 59.9% in Group 3. The overall survival rate in Group 1 was significantly better than that in Group 2 (p=0.0001) and Group 3 (p=0.0016). No significant difference in overall survival was found between Group 2 and Group 3. Age, number of metastatic lymph nodes, type of lymphadenectomy and type of adjuvant therapy were significantly and independently related to overall survival. Only when patients received PALX, PANM was a prognostic risk factor.
  
  
  CONCLUSIONS
  Sub-classification of stage IIIC would be functional for estimating prognosis in the revised FIGO staging system. Systematic lymphadenectomy including PALX has therapeutic significance for patients with stage IIIC endometrial cancer. Prognosis of patients with stage IIIC endometrial cancer would depend much more on application of lymphadenectomy including PALX than nodal status.
authors.affiliation: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan. yukiharu@sap-cc.go.jp
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Todo
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kato
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Minobe
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Konno
authors.forename: Mahito
authors.initials: M
authors.lastname: Takeda
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
mesh_terms: D000368:Aged; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000145:classification / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D015203:Reproducibility of Results; D015996:Survival Rate