Introduction/Background Lymph node (LN) metastasis in endometrial cancer (EC) is a major prognostic factor and determines adjuvant treatment. Our aim was to analyze the survival outcomes and prognostic factors in stage IIIC EC.

Methodology We evaluated a series of 91 patients diagnosed with LN metastasis after sentinel lymph node biopsy (SLN) and/or pelvic ± para-aortic lymphadenectomy at AC Camargo Cancer Center from May 2007 to December 2020.

Results Median age was 60 years. Most cases were grade 3 (56%), had lymphovascular space invasion (LVSI) (62.6%), and myometrial invasion ≥50%. 68.1%. Eleven (12.1%) patients underwent pelvic lymphadenectomy, 66 (72.5%) pelvic and para-aortic lymphadenectomy, and 14 (15.4%) had only SLN. Median pelvic lymph nodes (PLN) and para-aortic lymph nodes (PALN) dissected were 24.5 (range,1–65) and 14 (range,1–64), respectively. Eighty-one (89%) patients had PLN metastasis (median 2, range 1–22), and 35 (38.5%) PALN metastasis (median 2, range 1–24). After a median follow-up of 47, 26 cases recurred (distant recurrence, 92.3%). The 3-years disease free survival (DFS) and 5-years overall survival (OS) were 73.8% and 76%, respectively. Non-endometrioid histologies, presence of PALN metastasis and number of positive LN correlated to worse DFS and OS in univariate analysis. Moreover, non-endometrioid histologies and number of positive LN negatively impacted the risk recurrence and death in multivariate analysis.

Conclusion Non-endometrioid histologies and number of positive LN negatively impact survival outcomes in stage IIIC EC.

Disclosures None.