Survival outcomes in patients with undifferentiated endometrial carcinoma

Year 2019, Volume: 46 Issue: 1, 141 - 147, 03.03.2019

Alpaslan Kaban , Samet Topuz

https://doi.org/10.5798/dicletip.534852

Abstract

Objective: The
aim of this study was to investigate the clinicopathological features and
survival of patients with undifferentiated endometrial carcinoma (UEC).

Methods:
Patients who were operated between 2006 and 2014 for endometrial cancer (EC) in
the same center were retrospectively reviewed from the clinical archive. Data
were obtained from patient files. Survival curves and rates were calculated
using the Kaplan-Meier method, and differences in survival were evaluated using
the Log-Rank test.

Results: In
this study, 774 patients with EC were screened. According to the pathology
report, 14 (1.8%) had undifferentiated type histology. The mean age, parity and
body mass index (BMI) of the patients were 58.6 year (range 40-73); 3.28 (range
0-6) and 32.1 kg/m2 (range 22.8-41.7), respectively. Of the patients, 64% (n=9)
had deep myometrial invasion, 93% (n=13) had lymphovascular space invasion, and
57% (n=8) had cervical involvement. Tumor size was greater than 5 cm in 64%
(n=9) of the patients. Thirty five percent (n=5) of the patients were stage 1A,
21% (n=3) were stage 1B, 14% (n=2) were stage 2, 14% were stage 3C, and 14%
were stage 4. As adjuvant therapy, 21% (n=3) of the patients received
chemotherapy only, 14% (n=2) received radiotherapy only, and 57% (n=8) received
chemotherapy and radiotherapy together. The mean follow-up duration was 36
months (range 4-104). In this period, survival rates were 77% for early-stage
(FIGO 1-2) and 0% for advanced-stage (FIGO 3-4). The mean survival duration was
81 months in the early stage; 6.8 months in advanced stage (Log Rank test P
value= 0.001).

Conclusion:
According to this study, UEC is highly associated with pathological poor
prognostic factors such as deep myometrial invasion, lymphovascular space
invasion, cervical involvement and large tumor size. Patients with advanced
stage do not have the chance to survive. Long-term survival is possible if the
diagnosis and treatment of the disease is achieved while the tumor is limited
to the uterus.

Keywords

Undifferentiated, survival, prognosis, surgery

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