title: Clinical outcomes of stage I endometrial carcinoma patients treated with surgery alone: Siriraj Hospital experiences.
abstract: OBJECTIVE
  To evaluate the recurrence rates and patterns of failure in patients with stage I endometrial carcinoma after surgical staging without adjuvant therapy.
  
  
  METHODS
  Medical records of 229 patients with stage I endometrial carcinoma, treated with surgery alone between 2002 and 2010 at Siriraj Hospital were retrospectively reviewed. The primary objective of this study was recurrence rates. The secondary objectives were patterns of failure, disease-free survival, overall survival, and prognostic factors related to outcomes.
  
  
  RESULTS
  During median follow-up time of 53.3 months, 11 recurrences (4.8%) occurred with a median time to recurrence of 21.2 months (range, 7.7 to 77.8 months). Vaginal recurrence was the most common pattern of failure (8/11 patients, 72.7%). Other recurrences were pelvic, abdominal and multiple metastases. Factors that appeared to be prognostic factors on univariate analyses were age and having high intermediate risk (HIR) (Gynecologic Oncology Group [GOG] 99 criteria), none of which showed significance in multivariate analysis. The recurrence rates were higher in the patients with HIR criteria (22.2% vs. 4.1%, p=0.013) or patients with stage IB, grade 2 endometrioid carcinoma (9.4% vs. 4.3%, p=0.199). Five-year disease-free survival and 5-year overall survival were 93.9% (95% CI, 89.9 to 5.86) and 99.5% (95% CI, 97.0 to 99.9), respectively.
  
  
  CONCLUSIONS
  The patients with low risk stage I endometrial carcinoma had excellent outcomes with surgery alone. Our study showed that no single factor was demonstrated to be an independent predictor for recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suwanit
authors.identifier: http://orcid.org/0000-0002-0115-594X
authors.initials: S
authors.lastname: Therasakvichya
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sompop
authors.identifier: http://orcid.org/0000-0002-1892-0839
authors.initials: S
authors.lastname: Kuljarusnont
authors.affiliation: Division of Radiation Oncology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Janjira
authors.identifier: http://orcid.org/0000-0002-2334-4899
authors.initials: J
authors.lastname: Petsuksiri
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pattama
authors.identifier: http://orcid.org/0000-0001-7118-3340
authors.initials: P
authors.lastname: Chaopotong
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Vuthinun
authors.identifier: http://orcid.org/0000-0002-6635-9871
authors.initials: V
authors.lastname: Achariyapota
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pisutt
authors.identifier: http://orcid.org/0000-0002-6541-7304
authors.initials: P
authors.lastname: Srichaikul
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. ajaishuen@hotmail.com.
authors.forename: Atthapon
authors.identifier: http://orcid.org/0000-0001-7618-4609
authors.initials: A
authors.lastname: Jaishuen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D016896:Treatment Outcome
keywords: Endometrial Neoplasms; Stage I; Surgery