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Published on: September 12, 2019
Transection of vaginal cuff is an independent prognostic factor in stage I endometrial cancer
H Arndt-Miercke1, A Martin, V Briese
1Department of Obstetrics and Gynecology, University of Rostock, Klinikum Suedstadt, Suedring 81, 18059 Rostock, Germany.
Aims:
The objective was to identify prognostic factors of disease-free and overall survival in stage I endometrial carcinoma, thereby potentially facilitating the selection of patients who are on high risk for recurrence and who may benefit from transection of a vaginal cuff.
Methods:
In a retrospective review between 1994 and 2004, 340 patients with stage I endometrial carcinoma were managed surgically at two different hospitals in Rostock. The median follow-up was 79 (range 12-161) months. Clinical and histological parameters were compared using the SPSS software package.
Results:
In the univariate analysis the factors associated with poor disease-free survival in stage I carcinoma were higher tumor grade (P=0.013), and no removed vaginal cuff (P=0.025). The corresponding factor for impaired overall survival was no removed vaginal cuff (P=0.003). All parameters with a P-value<0.25 in the univariate setting were entered into a multivariate analysis. The factors that maintained associated with poor disease-free and overall survival were higher tumor grade and lack of vaginal cuff.
Conclusions:
The removal of a vaginal cuff during abdominal hysterectomy was found to be an independent prognostic factor in stage I endometrial carcinomas. A prospective surgical trial is needed to validate our results before changing current clinical practice.
