Treatment Outcomes of Advanced Stage Endometrial Carcinoma (Stage III-IV) and Related Factors

Objective: The aim of this study was to determine treatment response, the recurrence rate, 3-year overall survival, 3-year recurrence-free survival, and associated prognostic factors for survival among advanced-stage endometrial carcinoma patients at Siriraj Hospital. Methods: This study was conducted at the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok, Thailand. A total of 415 patients that were diagnosed with advanced-stage endometrial carcinoma during January 1998 to December 2014 were enrolled. Data retrieved from medical records included baseline characteristics, surgico-pathological reports, treatment protocol, follow-up data, treatment response, and recurrence status. Three-year survival and recurrence-free survival were estimated by Kaplan-Meier method. Various factors were analyzed for significant association with survival. Results: Four hundred of 415 cases were included in the final analysis. There were 282 (70.5%) and 118 (29.5%) patients that were diagnosed with stage III and IV disease, respectively. Two hundred and eighty-two patients had complete response after primary treatment, and 94 (33.3%) patients had disease recurrence. The median followup and survival times were 24.5 and 42.5 months, respectively. The 3-year survival rate was 50%, and the median recurrence-free interval was 12.25 months. Multivariate analysis revealed high-grade tumor histology, lymph node metastasis, Eastern Cooperative Oncology Group (ECOG) performance status, and menopausal status to be significant prognostic factors for overall survival. Conclusion: Median survival among patients with advanced-stage endometrial carcinoma after primary treatment was 3 years. The significant prognostic factors were high grade tumor histology, lymph node metastasis, ECOG performance status, and menopausal status.