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Survival outcomes of women with grade 3 endometrioid endometrial cancer: the impact of adjuvant treatment strategies

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

This multicenter investigation was performed to evaluate the adjuvant treatment options, prognostic factors, and patterns of recurrence in patients with grade 3 endometrioid endometrial cancer (G3-EEC).

Materials and methods

The medical reports of patients undergoing at least total hysterectomy and salpingo-oophorectomy for G3-EEC between 1996 and 2018 at 11 gynecological oncology centers were analyzed. Optimal surgery was defined as removal of all disease except for residual nodules with a maximum diameter ≤ 1 cm, as determined at completion of the primary operation. Adequate systematic lymphadenectomy was defined as the removal of at least 15 pelvic and at least 5 paraaortic LNs.

Results

The study population consists of 465 women with G3-EEC. The 5-year disease-free survival (DFS) and overall survival (OS) rates of the entire cohort are 50.3% and 57.6%, respectively. Adequate systematic lymphadenectomy was achieved in 429 (92.2%) patients. Optimal surgery was achieved in 135 (75.0%) patients in advanced stage. Inadequate lymphadenectomy (DFS; HR 3.4, 95% CI 3.0–5.6; P = 0.016—OS; HR 3.2, 95% CI 1.6–6.5; P = 0.019) was independent prognostic factors for 5-year DFS and OS.

Conclusion

Inadequate lymphadenectomy and LVSI were independent prognostic factors for worse DFS and OS in women with stage I–II G3-EEC. Adequate lymphadenectomy and optimal surgery were independent prognostic factors for better DFS and OS in women with stage III–IV G3-EEC.

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Funding

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Author information

Authors and Affiliations

  1. Department of Gynecologic Oncology, Mugla Sıtkı Kocman University Education and Research Hospital, Muğla, Turkey

    Kemal Gungorduk

  2. Department of Gynecology with Center for Oncological Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, 13353, Berlin, Germany

    Jumana Muallem, Jalid Sehouli, Andrea Miranda & Mustafa Zelal Muallem

  3. Department of Gynecologic Oncology, Ankara Education and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Osman Aşıcıoğlu

  4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Erciyes University, Kayseri, Turkey

    Varol Gülseren

  5. Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Mehmet Mutlu Meydanlı

  6. Department of Gynecologic Oncology, Dr. Sadi Konuk Training and Research Hospital, Faculty of Medicine, University of Health Sciences, İstanbul, Turkey

    Aykut Özdemir

  7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey

    Hanifi Şahin & Ali Ayhan

  8. Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Nurettin Boran

  9. Department of Gynecologic Oncology, Bagcılar Education and Research Hospital, Faculty of Medicine, University of Health Sciences, İstanbul, Turkey

    Taylan Şenol

  10. Department of Gynecologic Oncology, Zenyep Kamil Women’s Health Education and Research Hospital, Faculty of Medicine, University of Health Sciences, İstanbul, Turkey

    Taylan Şenol

  11. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Ege University, İzmir, Turkey

    Nuri Yıldırım

  12. Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Taner Turan

  13. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Eskişehir Osman Gazi University, Eskisehir, Turkey

    Tufan Oge

  14. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Ankara, Turkey

    Salih Taşkın

  15. Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey

    Ümran Küçükgöz Güleç, Ghanim Khatib & Mehmet Ali Vardar

Authors
  1. Kemal Gungorduk
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  2. Jumana Muallem
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  19. Ali Ayhan
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  20. Mustafa Zelal Muallem
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Contributions

Concept: KG, VG, MZM, JS, OA. Design: KG, VG, MMM, JS. Data Collection or processing: VG, JS, MM, AM, AO, HS, TS, NY, TT, TO, ST, AA, JM, NB. Analysis or interpretation: KG, VG, MM. Literature search: KG, VG, MM, GB, AO, HS, TS, NY, TT, TO, MAV. Writing: KG, MM, VG.

Corresponding author

Correspondence to Varol Gülseren.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Gungorduk, K., Muallem, J., Aşıcıoğlu, O. et al. Survival outcomes of women with grade 3 endometrioid endometrial cancer: the impact of adjuvant treatment strategies. Arch Gynecol Obstet 305, 671–681 (2022). https://doi.org/10.1007/s00404-021-06187-4

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