Stage I endometrial carcinoma: a review of 140 patients primarily treated by surgery only

One hundred patients with stage Ia and 40 patients with stage Ib endometrial carcinoma had hysterectomy and bilateral salpingo-oophorectomy performed as the only primary treatment. Sixty-two percent of the patients had well-differentiated tumors, 31% moderately differentiated, and 7% undifferentiated tumors. Information on myometrial invasion was not available. The overall 5-year survival was 0.92 and the 5-year survival by tumor grade 0.96, 0.90, and 0.80 for patients with grade 1, 2, and 3 tumors, respectively. Survival rates decreased significantly with increased tumor dedifferentiation. Prognosis was not affected by enlargement of the uterine cavity or by higher patient age. Of 7 cases of isolated vaginal or pelvic recurrence, 4 could by controlled by irradiation therapy. These results compared to reported results of combined therapy suggest, that in well-differentiated cases-the majority of stage I endometrial cancers-combined therapy of surgery and irradiation presents no advantage over simple hysterectomy.