Stage II cancer of the endometrium: a pathologic and clinical study

Pathologically documented cases of stage II cancer of the endometrium in 52 women (adenocarcinoma in 43 and adenoacanthoma in 9) who were treated between 1952 and 1973 at the Mayo Clinic were studied retrospectively. Hysterectomy was necessary for inclusion in the study; 49 women received planned primary surgical treatment of their disease, and, in addition, 25 patients received radiation treatment postoperatively. Overall survival was 69.2% at 5 years. Variables found to have a statistically significant influence on survival were (1) extent of involvement in the endometrial cavity, (2) histologic grade of the tumor, and (3) maximal depth of invasion in either the myometrium or the cervix. The presence of abnormal nodes in women who had Wertheim hysterectomies and the use of radiation therapy did not appear to influence survival. It is concluded that primary treatment of stage II carcinoma of the endometrium by surgery and postoperative radiation produces acceptable results and, through the advantages of surgical staging, provides more exact knowledge of the true extent of the disease.