Incidence of adnexal involvement among patients with clinical stage I endometrioid endometrial adenocarcinoma

Objectives: Evaluate the incidence and pathological factors associated with isolated adnexal involvement among patients with clinical stage I endometrioid endometrial adenocarcinoma undergoing hysterectomy. Methods: Patients without a history of another tumor diagnosed between 2010 and 2015 with clinical stage I endometrioid endometrial adenocarcinoma who underwent hysterectomy with bilateral salpingo-oophorectomy with known tumor grade, size, status of lymphovascular invasion (LVSI), peritoneal cytology and regional lymph nodes were selected from the National Cancer Database. Patients with adnexal metastases as the only site of intraperitoneal extra-uterine tumor spread were identified. Predictors of isolated adnexal involvement were identified with logistic regression. Overall survival (OS) of patients with and without adnexal involvement was compared with the log-rank test following generation of Kaplan-Meier curves. Results: A total of 17911 patients who met the inclusion criteria were identified; 161 (0.9%) had adnexal metastases. Incidence of adnexal metastases was lower for patients with grade 1 (0.6%) tumors compared to those with grade 2 (1%) and grade 3 (1.7%) tumors, p 4 cm (OR 2.71, 95% CI: 1.47, 5.00) and age Conclusions: Isolated adnexal involvement is rare among patients with clinical stage I endometrioid endometrial adenocarcinoma, and correlated with worse overall survival. Presence of LVSI and positive peritoneal cytology were the strongest predictors of adnexal involvement.