Factors related to recurrence in non-obese women with endometrial endometrioid adenocarcinoma.

AIM

To evaluate the clinicopathological factors associated with recurrence of disease in non-obese women with endometrial endometrioid adenocarcinoma.

METHODS

Medical records of the 138 patients who had newly diagnosed endometrial endometrioid adenocarcinoma with body mass index (BMI) <25 and underwent a complete staging surgery between 1999 and 2007 were reviewed.

RESULTS

The median age was 55 years (30–75 years). The median BMI was 21.3 (14.0–25.0). The International Federation of Gynecology and Obstetrics (FIGO) (1988) stages of the patients were as follows: 11 (8.0%) Ia, 30 (21.7%) Ib, 23 (16.7%) Ic, 5 (3.6%) IIa, 13 (9.4%) IIb, 12 (8.7%) IIIa, 2 (1.4%) IIIb, 38 (27.5%) IIIc, 4 (2.9%) IVb. Lymphovascular space invasion (LVSI) and lymph node metastasis was present in 73 (53%) and 38 (27.5%) patients, respectively. LVSI was significantly correlated with lymph node metastasis (P < 0.0001), advanced FIGO stage (P < 0.0001), poor histological grade (P = 0.006), and deep uterine invasion (P < 0.0001). The presence of LVSI, poor histological grade, and advanced stage were found significantly in patients who had disease recurrences (P = 0.026, P < 0.001, and P = 0.015, respectively). Patients with LVSI, when stratified by FIGO stage, had a significant lower 5-year overall survival rate (58.8% versus 76.3%, log–rank test, P = 0.04).

CONCLUSION

LVSI, poor histological grade, and advanced stage were associated with disease recurrence in non-obese women with endometrial endometrioid adenocarcinoma. Non-obese patients with LVSI-positive tumors tend to have a poorer survival rate than obese patients with LVSI-positive tumors.