Comparison of the prognostic significance of uterine factors and nodal status for endometrial cancer.
OBJECTIVE
We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer.


METHODS
Women with stage I-IIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion ≥50%, cervical stromal involvement, and grade 3 histology.


RESULTS
A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 63-72%) for group 1 (node positive/no RF) vs 69% (95% CI, 66-72%) for group 5 (node negative/multiple RF). Five-year survival was lower for node-positive patients with RF (58%; 95% CI, 54-61%) than node-positive patients without RF (68%; 95% CI, 63-72%).


CONCLUSIONS
Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Collage of Physicians and Surgeons, 161 Fort Washington Avenue, New York, NY 10032, USA.
Nicanor I
NI
Barrena Medel
Thomas J
TJ
Herzog
Israel
I
Deutsch
William M
WM
Burke
Xuming
X
Sun
Sharyn N
SN
Lewin
Jason D
JD
Wright
D000368:Aged; D018269:Carcinoma, Endometrioid / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D016019:Survival Analysis; D014481:United States; D014599:Uterus / Q000473:pathology*