Quantification of Recurrence Risk Based on Number of Adverse Prognostic Factors in Women with Early Stage Uterine Endometrioid Carcinoma

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Conference Proceeding

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International Journal of Radiation Oncology Biology Physics


Purpose/Objective(s): We sought to quantify the risk of recurrence in women with International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial carcinoma, solely of endometrioid based on the number of adverse prognostic factors.

Materials/Methods: We identified 1133 women at our institution who underwent a hysterectomy and did not receive any adjuvant therapy between 1/1990 and 12/2019. Cox proportional hazards model was used to identify independent predictors of recurrence. Prognostic groups were created based on the number of independent predictors of recurrence (0, 1 or 2 or 3 risk factors).

Results: Median follow-up was 84 months. Independent prognostic factors of recurrence included age ≥ 60, grade 2/3 and the presence of lymphovascular space invasion (LVSI). Due to small number in groups with 2 or 3 risk factors, these were combined into one group (group 2). Isolated vaginal cuff recurrence was the most common site of recurrence in the study groups (81%, 58% and 70% for groups 0, 1 and 2, respectively). Five-year recurrence rates were 4%, 15%, and 43% for groups 0, 1, and 2 (p<0.001), respectively. Five-year disease-specific survival were 99%, 96% and 85% and 5-year overall survival were 94%, 85% and 63% (p<0.001), respectively.

Conclusion: On the basis of 3 well-known prognostic factors, individualized recurrence rate can be predicted in women with stage I endometrial carcinoma. This simplified predictive tool may be helpful in estimating individualized risk of recurrence and guide counseling with regard to adjuvant treatment.





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