Prognostic factors in endometrial carcinoma: risk groups and adjuvant radiotherapy.
Prognostic factors for disease-free survival in patients with endometrial carcinoma have been retrospectively assessed in 611 cases diagnosed, treated and followed at our institution between 1971 and 1990. Age, symptoms, comorbidity, FIGO clinical stage, and hysterectomy, as well as size and location of the tumor, histologic type, FIGO grade, myometrial invasion, lympho-vascular invasion, and final surgical stage have all been evaluated by univariate and multivariate methods. A mathematical predictive model has been applied to define risk groups, and the applied adjuvant treatments have been evaluated according to these groups. One hundred and thirty-one patients were not treated primarily with surgery, and the actuarial 5 and 10-year disease-free survival was 51.6% and 34.7% respectively. Only clinical stage (FIGO 1971) and modality of radiotherapy were significant prognostic factors. For the 480 patients treated primarily by surgery, independent prognostic factors for 5 and 10-year disease-free survival in multivariate analysis were extrauterine spread, absence of diagnostic comorbidity, FIGO grades 2-3, lympho-vascular invasion, age > 65 years and cervical extension. Five and 10-year disease-free survival was 81.5% and 73.4% respectively. Three risk groups were obtained, whose survival was not affected by the adjuvant treatments applied.