Article Text
Abstract
Introduction/Background Our purpose is to evaluate the influence of surgical management and the prognostic factors for Disease-Free Survival (DFS) and Overall Survival (OS) in endometrial cancer (EC).
Methodology Retrospective review of 180 patients underwent standard surgical staging with pelvic and para-aortic lymphadenectomy in 130 cases. Mean age was 63 years (27–94). Mean BMI 30 kg/m2 (15–51). Mean Ca 1.25 prior to surgery was 61 U/dL (2–4,228). Mean removed nodes was 21 pelvic nodes (9–56, involved nodes 12.3%) and 19 para-aortic nodes (7–51, involved nodes 14.8%). A laparoscopic approach was performed in 65% patients. Mean follow-up was 46 months. The factors that impact on survival were compared using univariate and multivariate analysis.
Results The estimated 5-year DFS and OS comparated rates were respectively, according to FIGO local stages (I) 93.9 and 90.2%, vs advanced stages (II–IV) 0 and 53.7% (p=0.00 Hazard ratio 5.58 (CI 95%, 2.74–11.35) and p=0.00 Hazard ratio 4.19 (CI 95%, 2.11–8.34); obesity BMI <30 84 and 85.5%, vs BMI >30 82.7 and 80.8 (p=0.61 and p=0.38); preoperative Ca125 levels <35 U/dL 86.6 and 88.6%, vs Ca125 level <35 86.6 and 88.6% (p=0.17 and p=0.02 Hazard ratio 2.67 (CI 95%, 1.09–6.51); laparoscopic surgical approach 86.5 and 88.7%, vs laparotomy 58 and 75.4% (p=0.77 and p=0.27); complete surgical surgery 92 and 92%, vs incomplete 0 and 27.3% (p=0.00 Hazard ratio 3.64 (CI 95%, 1.48–8.39) and p=0.00 Hazard ratio 7.03 (CI 95%, 3.04–16.25); without lymphadenectomy 86.9 and 86.8%, vs performed lymfadenectomy 91.4 and 75.8% (p=0.01 Hazard ratio 2.94 (CI 95%, 1.21–7.16) and p=0.33); negative lymph involvement 81.9 and 85.9%, vs involved nodes 0 and 60% (p=0.00 Hazard ratio 3.17 (1.41–7.11) and p=0.01 Hazard ratio 3.22 (CI 95%, 1.2–8.62).
Conclusion DFS and OS increased in case of complete debulking, low Ca12.5 leves prior to surgery, the abscence of lymph involvement and patients who underwent lymphadenectomy.
Disclosure Nothing to disclose.