Current management of stage I adenocarcinoma of the endometrium.

Abstract

OBJECTIVE: This study was undertaken to assess the current management and outcome of patients with stage I adenocarcinoma of the endometrium. METHODS: One hundred thirty-five patients with stage I adenocarcinoma of the endometrium were treated with hysterectomy, bilateral salpingo-oophorectomy, and surgical staging. Patients were then stratified into high risk or low risk groups based on grade, depth of myometrial invasion, and the presence or absence of lymph-vascular space invasion. Postoperative treatment was then individualized based on risk assessment. RESULTS: Sixteen of 135 patients (12%) underwent postoperative adjuvant pelvic radiation. The remaining patients were treated with observation following surgery. Actuarial survival at three years was 97%. CONCLUSIONS: Surgical staging of endometria cancer provides critical information with regard to the extent of cancer and prognosis. When cancer is confined to the uterine corpus, histopathologic findings can be used to assess individual patient risk; high risk patients may then be selected for postoperative radiation. Relatively few patients will require adjuvant treatment and overall survival appears excellent.