Objectives High grade endometrial carcinoma limited to the endometrium or a polyp is a rare clinical entity. Currently there is no consensus on standard treatment. Thus, the goal of this study was to evaluate the clinical outcomes of patients with type II endometrial carcinoma without myometrial infiltration or limited to a polyp.
Methods We retrospectively identified type II endometrial carcinoma with spread limited to the endometrium or a polyp from April 2013 to November 2017. Medical records were reviewed for the following information: age at diagnosis, characteristics of patients, type of surgery, histology, stage according to FIGO 2009 classification, adjuvant treatments, and site of recurrence. Descriptive statistics and the Kaplan–Meier estimate were used for analysis.
Results Twenty-six patients with a type II stage IA adenocarcinoma were included. All were surgically staged with total hysterectomy, salpingo-oophorectomy and lymph nodes assessment. The median age at diagnosis was 69 years. All patients had either disease limited to the endometrium (61.5%) or a polyp (38.5%). Only four patients had lymphovascular space invasion (16.5%). Median follow up was 44 months (2–75 months). Most patients did not receive adjuvant treatment after surgery (73%). Three patients (11.5%) experienced recurrences 15, 21 and 55 months after surgery. Following systemic treatment all are alive and free of disease. The 3-year progression free survival and overall survival were 91% and 100% respectively.
Conclusions Based on our data, expectant management with surveillance alone following surgery appears to be safe for patients with high-grade endometrial carcinoma limited to a polyp or the endometrium without myometrial invasion.
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