Treatment variables in the management of endometrial cancer.

A review was made of 240 women with endometrial carcinoma who were treated at the University Hospital in Seattle, Washington, between 1961 and 1979. The most common predisposing factor was a history of exogenous hormones, elicited in 46.7%. As predicted, such patients exhibited a more favorable outcome. Twelve percent of patients developed recurrent disease, and the vagina was the most common site of recurrence. However, 85% of patients with vaginal recurrence had received preoperative radiation therapy. Nodal sampling was a phase of the primary surgical treatment of the disease in 41 of the 240 patients. An effort to focus on this issue was made by including in a separate review 26 additional patients similarly managed in 1980 and 1981, thereby raising to 67 the total number of patients with nodal sampling. Fifty-nine of these patients had Stage I endometrial cancer. In these patients, histologic grade of tumor and depth of invasion determined at the time of operation appear to serve as reasonable predictors of nodal involvement.