title: Survival after stage IA endometrial cancer; can follow-up be altered? A prospective nationwide Danish survey.
abstract: OBJECTIVE
  To present Danish national survival data on women with early stage endometrial cancer and use these data to discuss the relevance of postoperative follow-up.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Danish Endometrial Cancer Study (DEMCA).
  
  
  METHODS
  Five hundred and seventy-one FIGO stage IA (1988 classification) endometrial cancer patients prospectively included between 1986 and 1999. All patients had total abdominal hysterectomy and bilateral salpingo-oophorectomy without adjuvant therapy.
  
  
  METHODS
  The patient and the disease characteristics were drawn from the DEMCA database with cross-references to the national death registry and the national pathology database. Statistical methods included Kaplan-Meier, log-rank and Cox regression analysis.
  
  
  METHODS
  Survival rates in relation to histopathology.
  
  
  RESULTS
  The five year overall survival rate was 88.9% and five year disease-specific survival was 97.3%. Patients with low- (91.8%) and high-risk histopathology (8.2%) were compared. The age-adjusted overall and disease-specific survival differed significantly between women with low- and high-risk histopathology (p = 0.039 and p = 0.004, respectively). The disease-specific survival adjusted for age between patients with well-differentiated endometrioid tumors differed from those with moderately differentiated tumors (p = 0.008, hazard ratio = 3.75, 95% confidence interval 1.41-10.00). Recurrence data were available on 464 patients. Twenty-three (3.9%) experienced recurrence. Of these recurrences, 15 of 23 (65%) were vaginal. Death from recurrence was observed in nine of 23 (39%) patients, and five of these nine had vaginal recurrences.
  
  
  CONCLUSIONS
  Women with FIGO stage IA endometrial cancer have a very high disease-specific five year survival. Survival was related to histopathology. Follow-up at a highly specialized tertiary care center for patients with an extremely good prognosis may be questioned.
authors.affiliation: Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. lajer@dadlnet.dk
authors.forename: Henrik
authors.initials: H
authors.lastname: Lajer
authors.forename: Sandra
authors.initials: S
authors.lastname: Elnegaard
authors.forename: René D
authors.initials: RD
authors.lastname: Christensen
authors.forename: Gitte
authors.initials: G
authors.lastname: Ortoft
authors.forename: Doris E
authors.initials: DE
authors.lastname: Schledermann
authors.forename: Ole
authors.initials: O
authors.lastname: Mogensen
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology; D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000401:mortality / Q000473:pathology; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D010052:Ovariectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D058994:Salpingectomy; D015996:Survival Rate; D016896:Treatment Outcome