Endometrioid endometrial cancer – the prognostic value of selected clinical and pathological parameters

Abstract

Objectives: to assess the relationship between selected clinical and pathological factors and disease free survival (DFS) and overall survival (OS) in endometrioid endometrial cancer patients. Material and methods: A retrospective review of 262 patients aged 37-86 (6.0±9.0) was performed. Selected clinical and pathological data were correlated with DFS and OS. Results: Follow-up was 8-123 months (64.9±27.1). In 4 patients (1.5%) clinical progression was diagnosed during the treatment. In 43 patients (16.4%) relapse was diagnosed 2-61 months (23.9±15.7) after commencing treatment. DFS and OS were 82.1% and 81.3% respectively. In univariate analysis worse DFS was related to older patients (p=0.007) and non-radical surgery (p<0.001). In multivariate analysis worse DFS was related to older patients (HR=1.058; 95%CI=1.024-1.093; p<0.001), younger at menopause (HR=0.910; 95%CI=0.851-0.973;p=0.006), with higher staging (HR=2.639; 95%CI=1.968-3.539; p<0.001) operated non-radically (HR=0.220;95%CI=0.096-0.504; p<0.001). In univariate analysis worse OS was connected with older patients (p=0.018), diabetes type II (p=0.019) and non-radical surgery (p<0.001). In multivariate analysis worse OS was related to younger age at menopause (HR=0.932; 95%CI=0.873-0.996; p=0.039), diabetes type II (HR=2.372; 95%CI=1.260-4.466; p=0.008), higher staging (HR=2.053; 95%CI=1.482-2.845; p<0.001), and non-radical surgery (HR=0.240;95%CI=0.091-0.636; p=0.004). Conclusions: Relapsed endometrial cancer developed in 90.7% during four years after commencing treatment. In 79.1% of these patients distant metastases were present. Most significant prognostic factors were radicality of surgery, age of patients and staging. The presence of diabetes type II and early menopause were connected with worse prognosis.