Comparison of the prognostic significance of uterine factors and nodal status for endometrial cancer

Abstract

Objective: We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer.

Study design: Women with stage I-IIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion ≥50%, cervical stromal involvement, and grade 3 histology.

Results: A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 63-72%) for group 1 (node positive/no RF) vs 69% (95% CI, 66-72%) for group 5 (node negative/multiple RF). Five-year survival was lower for node-positive patients with RF (58%; 95% CI, 54-61%) than node-positive patients without RF (68%; 95% CI, 63-72%).

Conclusion: Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis.