title: Risk factors for recurrence amongst high intermediate risk patients with endometrioid adenocarcinoma.
abstract: OBJECTIVE
  To determine risk factors associated with recurrence in patients with high intermediate risk (HIR) endometrioid adenocarcinoma.
  
  
  METHODS
  A retrospective analysis of patients with HIR endometrioid adenocarcinoma who underwent hysterectomy, bilateral salpingo-oophorectomy, with or without pelvic/para-aortic lymphadenectomy at the University of Pennsylvania between 1990 and 2009 was performed.
  
  
  RESULTS
  A total of 103 women with HIR endometrial cancer were identified. Multivariable analysis revealed that ≥2/3 myometrial invasion (HR, 4.79; p=0.010) and grade 3 disease (HR, 3.04; p=0.045) were independently predictive of distant metastases. The 5-year distant metastases free survival (DMFS) for patients with neither or one of these risk factors was 89%, and the 5-year DMFS for patients with both risk factors was 48% (p<0.001).
  
  
  CONCLUSIONS
  Patients with both grade 3 disease and deep third myometrial invasion have a high risk of distant metastases. Identifying these patients may be important in rationally selecting patients for systemic therapy.
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Agnes Y
authors.initials: AY
authors.lastname: Bahng
authors.forename: Christina
authors.initials: C
authors.lastname: Chu
authors.forename: Paul
authors.initials: P
authors.lastname: Wileyto
authors.forename: Stephen
authors.initials: S
authors.lastname: Rubin
authors.forename: Lilie L
authors.initials: LL
authors.lastname: Lin
keywords: Chemotherapy; Endometrial neoplasms; High intermediate risk; Radiotherapy