Prognostic factors in endometrial cancer Stages III and IV: a single academic institution experience of 49 patients

Background: To evaluate the clinical and pathologic factors associated with survival in patients with advanced staged endometrial carcinoma. Matreials and Methods: Between 2005 and 2017 all patients with endometrial carcinoma type I were identified from tumor registry databases at this Academic hospital. The impact of clinical and pathologic risk factors on the survival of patients with endometrial carcinoma was evaluated using Kaplan-Meier life table analyses and log-rank tests. Results: Forty-nine patients with advanced endometrial cancer were collected. The median progression-free survival (PFS) for all patients was 42 months whereas the median overall survival (OS) was 69 months for all patients. Univariate analysis was extended to all prognostic factors for all stages showed as statistically significant positive cytology and cervical invasion, whereas for Stage III only cervical invasion. For Stage IIIA the prognostic factors statistically significant were cervical invasion and lymphovascular space invasion (LVSI). Furthermore, prognosis was worse in tumors belonging to Stage IV with positive cytology. Conclusion: Prognostic factors related to a lower survival rate in advanced stages of endometrial cancer are represented by cervical invasion, LVSI, and positive peritoneal cytology. These factors with respect to LVSI and positive peritoneal cytology should be included in FIGO 2009 surgical staging system because associated to a poor prognosis.