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Prognostic factors in endometrial cancer Stages III and IV: a single academic institution experience of 49 patients

Endometrial cancer is the most frequent malignancy of the female genital tract in all countries, and accounts for about 6% of all newly diagnosed cancer and for about 3% of cancer deaths [1]. Since vaginal bleeding is commonly associated to the presence of disease, more than 75% of endometrial cancer cases are diagnosed at early stage, resulting in overall favourable prognosis, with a five–year overall survival (OS) and cancer-specific survival rates of 80% to 85% and 90%, to 95 %, respectively [2, 3]. Only 5%–10% of endometrial cancer patients had Stage III-IV disease. For those patients, the prognosis remains poor and the optimal adjuvant therapy is yet to be established [2]. Therefore, advanced endometrial cancer provides a therapeutic challenge for the oncologist. A subset of these patients may benefit from hormonal manipulation, systemic chemotherapies, or combination treatment with volume-directed radiotherapy and systemic chemotherapy. The choice of therapy depends on the extent of residual disease after initial surgery, and the intent of treatment, is if it should be curative or palliative. Given the poor prognosis, it is important to identify prognostic factors responsible for survival in an effort to improve treatment strategies. In this current series of patients with endometrial cancer Stages III and IV the authors identified the clinical and pathologic prognostic factors responsible for survival. Furthermore, various therapeutic strategies in the treatment of this aggressive cancer were investigated.