Stage IV endometrial carcinoma: a clinical and histopathological study of 83 patients

From 1960 to 1977, eighty-three patients with stage IV endometrial carcinoma were treated in the Norwegian Radium Hospital. The lung was the main site of extrapelvic tumor extension (36%), followed by "multiple sites" (23%), lymph nodes (inguinal, supraclavicular, axillar; 13%), and bladder (13%). The actuarial 5-year-survival rate was 10%. Complete clinical remission was achieved in 5 patients with lung metastases, in 2 with inguinal lymph node metastases, and in 1 patient with ascites with positive cytology. Control of pelvic disease could be achieved in 20 of 72 patients (28%) by radiotherapy alone or combined with surgery and/or progestagens. Progestational agents proved to be of benefit especially for patients with lung metastases. A complete remission of all visible lesions was observed in 8 out of 26 patients (31%). Patients with well- and moderately differentiated primary adenocarcinoma had a response rate of 83% as opposed to 14% for patients with poorly differentiated adenocarcinomas and adenosquamos carcinomas. Extrapelvic tumor localizations, suitable for radiotherapy, were supraclavicular and axillary lymph nodes and bone metastases.