Introduction/Background Women with advanced endometrial cancer include a heterogeneous group with high local and systemic disease recurrence. The prognosis for these patients remains poor and optimal treatment strategies are yet to be established.

The objectives were to assess the overall and disease free survival in patients with advanced (Stage III and IV) endometrial cancer who undergo cytoreductive surgery, and to assess the factors affecting recurrence.

Methodology 80 patients with advanced endometrial cancer who had undergone surgery in Regional Cancer Centre Thiruvananthapuram between 2008 and 2018 were included.

Results Mean age was 59.9 yrs. 81.2% of the patients had stage III and 18.8% had stage IV endometrial cancer. 66.3% had endometrioid histology while 15% had serous carcinoma, 7.5% had clear cell carcinoma and 11.2% had carcinosarcoma. 69 (86.3%) patients had primary surgery, while 11 (13.7%) had upfront chemotherapy or radiotherapy before surgery. 90% of the patients had a complete cytoreduction. Post operative adjuvant treatment was chemotherapy and radiation in 51.2% patients, chemotherapy alone in 18.8% and radiotherapy alone in 21.3%. Median follow up was 92 months. 62.5% of the patients had a relapse. 5 year DFS was 39% and OS was 46.9%. Factors significantly correlating to recurrence on univariate analysis included age> 60 years, non endometrioid histology, high grade, LVSI and nodal involvement. On multivariate analysis, only non endometrioid histology significantly correlated with recurrence. Factors significantly correlating to OS were age > 60 yrs, Albumin < 4 g%, non endometrioid histology, high grade, presence of LVSI and site of recurrence in lung and para aortic lymph nodes. On multivariate analysis, only non endometrioid histology significantly correlated with survival.

Conclusion In carefully selected patients with advanced endometrial cancer, a combination of surgical cytoreduction with appropriate adjuvant treatment and neoadjuvant treatment when indicated gives good results with an acceptable morbidity and mortality and reasonable overall survival.

Disclosures None.