Introduction/Background The rate of recurrence of endometrial cancer is 11–19%. It is related to different prognostic factors which define specific risk classes in order to decide for an adjuvant treatment. The objective of this study is to evaluate how prognostic factors influence the probability and pattern of recurrence.

Methodology This multicentric observational retrospective study was conducted on 552 patients treated for endometrial cancer between February 2011–2019. The considered parameters were: age, BMI (Body Mass Index), surgery, stage, LVSI (Lymphovascular Space Involvement), myometrial infiltration, histological grade, lymph node involvement, adjuvant therapy, relapse. DFS (Disease Free Survival) and OS (Overall Survival) were stratified by the presence or absence of prognostic factors.

Results The rate of recurrence was 14,7%. Median time to recurrence was 15 months and 5-years OS was 84%. We observed an increase from 6 to 30% in the distance metastasis rate associated with positive LVSI. Monovariate analysis showed a correlation between DFS and advanced stage (O.R. II 6.7; III-IV 9.2 p=0,0001), positive lymph nodes (O.R. 3.7; p=0,04), myometrial infiltration (O.R. 3.9 p=0,0001) and LVSI (O.R. 3.5 p=0,005). Similar results were observed considering OS and grading (p=0,002). We conducted a Cox multivariate analysis on the ESGO/ESMO/ESTRO risk class classification and results were statistically significant for both DFS (p=0,003) and OS (p=0,0001).

Conclusion Almost all the considered prognostic factors influence the presence of recurrence, but the stage is the most important factor while LVSI correlates with distance metastasis. The definition of the risk factors must be considered to develop targeted therapeutic pathways.

Disclosures The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest.