Surgical Outcomes, Risk Factors, and Patterns of Recurrence in Endometrial Cancer

ABSTRACT

Introduction: Endometrial cancer (EC), being the third most common gynecologic cancer, is now increasing in prevalenceamong the developed countries. The morbidity and mortality rates are rising gradually in spite of available advancing treatmentmodalities. This study aims to brief on the patterns and risk factors of recurrence and surgical outcomes of EC.Aim: This study aims to study the patterns of recurrence and surgical outcomes of EC based on surgical and adjuvant therapy.Materials and Methods: The study was conducted among 60 women with EC in a tertiary care center. Disease staging wasdone by 2009 FIGO criteria. Post-operative adjuvant therapy in the form of pelvic radiation or vaginal radiation was offeredalong with chemotherapy to appropriate patients. The risk factors, surgical outcomes, and prognostic factors were studied byradiological imaging and blood parameters.Results: The mean age of the occurrence of EC was 51.22 years and abnormal uterine bleeding was the common presentingsymptom. About 86.6% of the patients underwent total abdominal hysterectomy and 52 of 60 patients required bilateral salpingooophorectomy (BSO). Pelvic lymph node dissection was done in 47 cases (61.6%) and 10 cases (16.6%) needed para-aorticnode dissection. Laparoscopic vaginal hysterectomy with BSO was done in one patient due to associated comorbidity. Onepatient needed only vaginal hysterectomy due to early-stage disease. The complication rate in this series was found to be 15%(9/60 cases). Two recurrences and one reported death were noticed.Conclusion: EC is common in postmenopausal women and comprehensive surgery, adjuvant radiotherapy and chemotherapycan help in reducing disease recurrence. Open surgery and minimally invasive surgery both have more or less equal outcomes.