Shanmugasundaram Gouthaman1, Roshni Saravanan2, Sivasundari Maharajan3, Ravi Shankar Pitani4, Jagadesh Chandra Bose Soundarajan5
BACKGROUND
Endometrial carcinoma is a leading malignancy among females. Pre-operative
imaging and biopsy are necessary to identify the disease. Clinicopathological
analysis determines the extent of the disease. Complete surgical staging is advised
for high-risk patients. The purpose of this study was to analyze the different clinical
endpoints, prognostic factors and demographic details that will influence the
survival patterns of the cases of carcinoma of endometrium who underwent
surgery during the period from 2014 to 2017 at a tertiary care centre, Chennai,
India.
METHODS
Patients diagnosed with operable endometrial carcinoma were surgically staged
based on the surgical procedures performed namely, total abdominal
hysterectomy (TAH) with bilateral salphingo-oophorectomy (BSO), bilateral pelvic
lymph node dissection, and para-aortic lymphadenectomy (patients with high-risk
features). Post-surgical staging specimens were histopathologically examined in
the Department of Pathology. Adjuvant radiation was given to patients with stage
IA grade II and above. Patients with stage III disease received adjuvant
chemotherapy. Descriptive analysis was done to show the distributions of patients
accordingly. Kaplan-Meier survival analysis was performed for the overall median
survival of the patients.
RESULTS
The study consisted of a total of 35 patients with a mean age of 56 ± 8.64.
Parameters such as age, clinicopathological features, stage (FIGO staging), tumor
size, grade, lymphovascular invasion (LVI), myometrial invasion, cervical
involvement, involvement of margins, lymph node ratio (LNR) and survival were
studied. Tumor size and grade were found to be significant factors affecting the
survival. Overall median survival period of patients who underwent surgery was
found to be 31 months.
CONCLUSIONS
Tumor size and grade of the tumor are significant prognostic factors affecting the
survival of the patients with carcinoma of endometrium. Lymph node ratio is a
new concept in carcinoma endometrium to be pondered upon as a factor
predicting survival in future studies thereby defining the role of lymph node
dissection in surgical staging.
