IMR Press / EJGO / Volume 40 / Issue 5 / DOI: 10.12892/ejgo4627.2019
Open Access Original Research
Outcomes of treatment for Stage III endometrial carcinoma patients
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1 Division of Gynecologic Oncology, Department of Obstetrics-Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
2 Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Eur. J. Gynaecol. Oncol. 2019 , 40(5), 803–809; https://doi.org/10.12892/ejgo4627.2019
Published: 10 October 2019
Abstract

Purposes: To report the outcomes and patterns of failure of Stage III endometrial carcinoma. Materials and Methods: Medical records of Stage III endometrial carcinoma patients were retrospectively reviewed. Disease-free survival (DFS) and patterns of failure were reported. Factors to predict pelvic and extra-pelvic recurrences were described. Results: Seventy-nine patients with Stage III endometrial carcinoma were included. Most had Stage IIIA (53%) and IIIC disease (33%) with endometrioid cell types (73%). Fifty-five percent of patients received chemotherapy (CMT) alone, 25% received external beam radiation therapy (ERT) alone, 20% received a combination of CMT and ERT. Median follow up time was 47 months. The two-year DFS rate was 78.5%. Pelvic and extra-pelvic recurrences were found in 6.3% and 15.2%, respectively. Major pattern of failure for Stage IIIA was pelvic recurrences, whereas most of Stage IIIC disease failed at the extra-pelvic sites. Conclusion: Adjuvant CMT is essential, especially in Stage IIIC disease. Pelvic lymph node dissection appeared to be a significant prognostic factor for pelvic recurrence. Stage IIIC disease, lymphovascular space invasion, gross residual disease after surgery, received ERT alone or sequential CMT/ERT was found to be factor to predict extra-pelvic recurrences.

Keywords
Endometrial carcinoma
Stage III
Outcome
Pattern of failure
Figures
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