Impact of surgical resection extent on the prognosis of clinical stage I endometrial carcinoma

Objective To investigate the impact of surgical resection extent and other clinicopathological characteristics on the prognosis in patients with clinical stage Ⅰ endometrial carcinoma. Methods The data of 135 surgically treated patients with clinical stage Ⅰ endometrial carcinoma were retrospectively analyzed. Fifty-seven patients （group A ） underwent simple hysterectomy and salpingo- oophorectomy with or without pelvic lymphadenectomy. The other 78 patients （group B） received sub-radical or radical hysterectomy and salpingo-oophorectomy with or without pelvic lymphadenectomy. The impact of surgery extent and other clinicopathological characteristics on the prognosis in patients with clinical stage Ⅰ endometrial carcinoma were retrospectively analyzed. Results There were no significant differences between two groups in the pathological stage, pathologic type, tumor grade, depth of myometrial invasion, vascular tumor emboli, ovary invasion, lymph node metastasis, positive peritoneal cytology and adjuvant therapy （P 〉0.05）. However, the patients in group A had a significantly shorter operating time （105 vs. 145 min）, less estimated blood loss （150 vs. 300 ml） and blood transfusion （0 -600 vs. 0 - 1200 ml）, and a shorter postoperative hospital stay （12 vs. 13 days） than that in group B （all P 〈 0.05 ）. The overall rates of post-operative complications were 15.8% in group A versus 26.9% in group B （P 〉 0.05 ）. The recurrence rate in the group A was 14.0% versus 6.4% in group B （ P 〉 0. 05 ）. Furthermore, the five-year survival rate in group A was 76.9% versus 85.8% in group B （P 〉0.05）. Multivariate analysis demonstrated that the important risk factors for clinical stage Ⅰ endometrial carcinoma were deep myometrium invasion, high pathological grade, positive peritoneal cytology and ovarian metastasis, rather than surgical resection extent. Conclusion Surgery extent is not an important factor affecting the prognosis in patients with clinical stage Ⅰ endometrial carcinoma, and extended surgery does not improve their survival. Therefore, excessive resection should be avoided in such cases. Key words: Endometrial neoplasms;  Surgical resection extent;  Prognosis