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274 Oncologic outcomes in women with low-intermediate risk endometrial carcinoma
  1. Yun Wang1,
  2. Pernille Bjerre Trent2,3,
  3. Gunn Fallås Dahl4,
  4. Brynhildur Eyjolsdottir6,
  5. Ben Davidson1,
  6. Kjersti Vassmo Lund2,
  7. Anne Cathrine Staff4,3 and
  8. Ane Gerda Zahl Eriksson6,8
  1. 1Department of Gynecologic Oncology, Oslo, Norway
  2. 2Division of Cancer Medicine, Oslo, Norway
  3. 3Faculty of Medicine, Oslo, Norway
  4. 4Oslo University Hospital, Oslo, Norway
  5. 5Institute of Clinical Medicine
  6. 6Norwegian Radium Hospital, Oslo, Norway
  7. 7University of Oslo
  8. 8Institute of Clinical Medicine, Oslo, Norway


Introduction/Background Surgery for endometrial carcinoma in Norway is centralized, except for women with assumed low/intermediate-risk disease. Nodal assessment is not routinely performed in these women. We sought to compare oncologic outcomes between women with preoperative grade1 stage IA and stage IB (G1 IA/IB).

Methodology All cases with preoperative G1 IA/IB referred to our center from 2006–2021 were evaluated for progression-free survival (PFS) and disease-specific survival (DSS).

Results In total, 518 women were included. Of these, 21/518 (5%) women were >stage I and 68/518 (13%) had >G1 histology on final pathology. Women with discrepant stage or histology had significantly worse PFS; stage I vs >stage I (p<0.001), G1 vs >G1 (p=0.006).

Of 435 women with G1 IA/IB on final pathology, 14% (51/358) preoperative stage IA were up-staged to IB postoperatively, and 52% (44/77) preoperative stage IB were down-staged to IA postoperatively. With a median follow-up time of 84 months, 5.5% (24) recurred, 15 with vaginal recurrence, 1 with pelvic recurrence, 3 with distant metastasis and 5 with multiple metastasis. In univariate analysis, preoperative stage IB, lympho-vascular space invasion and age ≥75 years were significantly related to increased risk of recurrence. Preoperative stage IB was significantly related to poorer DSS (p=0.008). In multivariate analysis, none of these variables were independent risk factor for recurrence. However, preoperative stage IB remained near significant for worse DSS (p= 0.059).

Conclusion We demonstrate significant discrepancies between preoperative assessment and final pathology for histology and myoinvasion for women with assumed low-intermediate risk disease, as well as poorer prognosis for women with preoperative G1 stage IB compared to those with G1 stage IA. These findings support the notion that low-risk endometrial cancer is a postoperative diagnosis, and that comprehensive surgical staging including nodal assent should be performed in all G1 cancers.

Disclosures Attached

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