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414 The prognostic impact of clinical and uterine factors in stage I endometrial cancer with negative lymph-vascular space invasion
  1. B Brandt,
  2. D Basaran,
  3. C Shepherd,
  4. N Ali,
  5. E Thompson,
  6. K Leong,
  7. A Moon,
  8. M Kuznicki,
  9. MM Leitao,
  10. NR Abu-Rustum and
  11. JJ Mueller
  1. Memorial Sloan Kettering Cancer Center, Gynecologic Oncology, New York, USA


Objectives To evaluate the impact of depth of invasion (DOI) and histology on survival of patients with stage I endometrial cancer (EC) with negative lymph-vascular space invasion (LVSI).

Methods All patients with stage I EC, negative LVSI and negative peritoneal washings, who underwent surgical staging at our institution between 01/2006–12/2016 were retrospectively reviewed. Appropriate statistical tests were employed.

Results We identified 1458 patients: median age 60 years (range, 27–92), median BMI 30 (range, 15–68), diabetes mellitus (DM)- 12%, invasion<50%- 96%, invasion≥50%- 4%, grade 1–2- 79%, grade 3- 21%, endometrioid- 85%, non-endometrioid- 15%, adjuvant radiotherapy- 30%, adjuvant chemotherapy- 12%. Median follow-up time was 29 months (range, 1–149). Overall 2-year disease specific survival rate (DSS) was 98.6% (SE 0.4%). On univariable analysis, non-endometrioid histology was associated with worse DSS compared with endometrioid histology (95.4% [SE 1.5%] vs 99.3% [SE 0.3%], p=0.001). DOI, race, BMI and surgical approach (minimally invasive vs open) did not correlate with DSS. On multivariable analysis, grade, DM and age were the only independent factors significantly associated with DSS (grade 3 vs grade 1–2: DSS 95.3% [SE 1.3%] vs 99.6% [SE 0.2%], p<0.001, HR 6.7 [95% CI 2.6–17.2]; DM vs non-DM: DSS 98.0% [SE 1.4%] vs 98.6% [SE 0.4%], p=0.001, HR 2.7 [95% CI 1.3–5.6]; age≥65 vs age<65: 97.8% [SE 0.8%] vs 99.0% [SE 0.4%], p<0.001, HR 2.3 [95% CI 1.2–4.5]).

Conclusions Disease specific survival of patients with stage I endometrial cancer without lymph-vascular invasion is determined by histologic grade, diabetes mellitus and age, but not by depth of invasion.

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