Adenocarcinoma of the endometrium stage I. Treatment, survival and recurrence

Survival after treatment of stage I endometrial adenocarcinoma was studied in a material of 111 patients, median follow-up period 6 years. Routine treatment was preoperative intrauterine and vaginal radium followed, in 6 weeks, by total hysterectomy and bilateral salpingo-oophorectomy. The 5-year corrected survival after treatment by operation and/or irradiation was 93%, after irradiation alone 87%. A significantly better survival was found in stage Ia (95%) than in stage Ib (83%) and also in patients with grade 1 tumors (97%) than in those with grade 3 tumors (71%). 21% of the patients had a residual endometrial tumor after preoperative radium, and among them survival was significantly lower than in patients without residual tumor. The recurrence rate was 11.7%. Vaginal metastases did not occur. Our routine treatment afford satisfactory results in stage I, grade 1 and 2. However, supplementary treatment must be recommended in the case of grade 3 tumors, of myometrial deep invasion, and of residual tumor following preoperative radium therapy.