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EPV131/#545 Lower uterine segment involvement in high-grade endometrial carcinoma is not independently associated with adverse oncological outcome
  1. B Brandt1,
  2. T Perri1,
  3. L Helpman2,
  4. R Eitan3,
  5. Z Vaknin4,
  6. O Lavie5,
  7. A Ben Arie6,
  8. A Amit7,
  9. T Levy8,
  10. A Namazov9,
  11. I Ben Shachar10,
  12. I Atlas11,
  13. I Bruchim12,
  14. G Levin1 and
  15. O Gemer13
  1. 1Hadassah Medical Center, Gynecologic Oncology, Jerusalem, Israel
  2. 2Cheba Medical Center, Gynecologic Oncology, Ramat Gan, Israel
  3. 3Rabin Medical Center, Gynecology, Petah Tikva, Israel
  4. 4Assaf Haroffe Medical Center, Sackler School of Medicine, Gynecology, Zrifin, Israel
  5. 5Carmel Medical Center, Obstetrics and Gynecology, Haifa, Israel
  6. 6Kaplan Medical Center, Hebrew University, Gynecology, Rehovot, Israel
  7. 7Rambam, Gymecologic Oncology, Haifa, Israel
  8. 8Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Gynecology, Tel Aviv, Israel
  9. 9Ahmet, Gynecology, Ashkelon, Israel
  10. 10ZIv, Gynecologic Oncology, Zefat, Israel
  11. 11Poriah, Gynecologic Oncology, Tiberia, Israel
  12. 12Hillel Yafe, Gynecology, Hadera, Israel
  13. 13Barzilai Medical Center, Gynecology, Ashkelon, Israel


Objectives To evaluate the association of lower uterine segment involvement (LUSI) in high-grade endometrial cancer (HGEC) with oncological outcome.

Methods We performed a retrospective multi-center cohort study of consecutive women with HGEC stages I-III who underwent surgery in nine gynecological oncology centers in Israel. Recurrence-free and overall survival were compared between both groups. Univariate, Kaplan-Meier survival and Cox proportional hazard model analyses were used.

Results Overall 432 women, 152 with and 280 without LUSI were followed for a median time of 35 months (interquartile range 17–71). Both groups were comparable in demographical and medical history characteristics. Cancer histological type did not differ between groups with uterine serous carcinomas and grade 3 composing 39.1% and 33.3% of the cohort. Carcinosarcoma and clear cell histology composed the rest. Women with LUSI had higher rates of ≥stage II disease (58.6% vs. 22.1%, p<0.001) and lower rate of lymphovascular space invasion (LVSI) (66.4% vs. 79.3%, p=0.003). LUSI was associated with an Odds Ratio for disease recurrence of 1.7 (95% Confidence Interval 1.1–2.6). Univariate survival analysis underlined shorter median overall survival among LUSI women (28 months vs. 41, p<0.001). Cox proportional hazards model adjusted for LVSI, age, disease stage and chemotherapy demonstrated that LUSI was not independently associated with decreased OS.

Conclusions In women with HGEC, the presence of LUSI is not an independent poor prognostic factor.

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