Endometrial cancer: evaluation of spread and follow-up one hundred eighty-nine patients with Stage I or Stage II disease.

A retrospective study was undertaken of 189 patients with Stage I or Stage II endometrial cancer in whom selective lymphadenectomy had been performed between the years 1974 and 1981. Pelvic and para-aortic nodal involvement increased with increasing stage, grade, and depth of myometrial invasion. The incidences of pelvic and para-aortic node metastases in Stage I were 1.4% and 3.8%, respectively, while 17.6% of Stage II patients had para-aortic metastases. Mortality was significantly greater for Stage I adenosquamous carcinoma (10.5%) and papillary serous adenocarcinoma (37.5%) than for Stage I adenocarcinoma (2.2%). In Stage I, grade 3 nonrandomized cases of endometrial cancer, no significant difference in survival or morbidity occurred between those patients treated with external radiation and those who were not. Intraperitoneal or adnexal spread occurred in 12 of the 189 patients, and lymph nodes were diseased in two of these. Sixteen of 17 recurrences developed at extrapelvic sites, indicating the need for effective systemic chemotherapy in high-risk patients. The overall 5-year survival rates for Stage I and II patients were 88.0% and 83.3%, respectively.