Objectives To study whether lower uterine segment involvement (LUSI) correlates with oncological outcomes in women with stage IA endometrial carcinoma with low risk features.
Methods We performed a retrospective multi-center cohort study of consecutive women with stage IA EC, who underwent complete surgical staging in eight gynecologic oncology centers in Israel. We included only women with grade 1–2 endometrioid histology, with negative lymphovascular space invasion, and those who did not receive adjuvant therapy. Univariate analysis, Kaplan-Meier survival and Cox proportional hazard models analysis were used to compare survival outcomes between women with and without LUSI.
Results We identified 283 cases for analysis. LUSI was diagnosed in 25 (8.8%). Media follow up was 72 months (interquartile range 40–144). There were no significant differences between both groups with regard to the following parameters: age, medical history, duration of symptoms, tumor grade and time from diagnosis to surgery. Overall 5-year survival and 5-year progression free survival were similar between the groups (log rank test p=0.993, p=0.244, respectively). Recurrence rate did not differ between groups (0% in LUSI vs. 5.0% in No LUSI groups, p=0.614). In Cox regression model adjusting for age, comorbidities and tumor grade – LUSI was not associated with overall survival (p=0.556).
Conclusions In women with stage IA EC with low-risk features, the presence of LUSI does not correlate with oncological outcome. LUSI as a sole finding should probably not dictate a decision upon adjuvant management in this low-risk population.
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