[Experience with endometrial carcinoma]

A series of 261 patients with endometrial carcinoma treated between 1980-1987 was retrospectively analyzed. There were 154 pathological Stage I cases, 37 Stage II, 30 Stage III, and 2 Stage IV. Most patients were treated by surgery combined with radiotherapy; 33 were treated by brachytherapy and/or external irradiation alone. While most received postoperative irradiation, a minority received preoperative irradiation. The actuarial 5-year disease-free survival was 79% for all patients, and 89%, 85% and 60% for Stages I, II, and III patients, respectively; 2 in Stage IV died shortly after diagnosis. The 5-year survival probability for 25 clinical Stage I-II patients treated by radiotherapy alone was 32%. Univariate analysis revealed that prognosticators of survival included histological subtype (papillary carcinoma vs other histological types, p less than 0.001), and degree of differentiation (Grade III vs Grades I-II, p less than 0.001). The prognosis of Stage I patients with deep myometrial invasion was markedly improved by adjuvant irradiation. The disease recurred in 50 patients (19.1%): 3 developed isolated vaginal recurrence, 7 had pelvic recurrence, and 40 developed distant metastases, with or without locoregional failure. The probability of 5-year survival was 50% for those with pelvic recurrence, and 9% for those with metastatic spread; 3 with isolated vaginal recurrence died within less than 40 weeks after diagnosis of recurrence. Risk factors for locoregional and/or distant failure were histologic subtype (papillary vs other histologic types, p = 0.001) degree of malignancy (Grade III vs Grades I-II, p = 0.001) and myometrial invasion (deep vs superficial, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)