Comparison of the prognostic significance of uterine factors and nodal status for endometrial cancer

Objective We examined the prognostic significance of uterine risk factors (RF) compared to nodal metastases in endometrial cancer. Study Design Women with stage IIIIC endometrioid cancer were stratified based on the presence of positive or negative lymph nodes. Each patient was characterized by the number of RF present: myoinvasion <50%, cervical stromal involvement, and grade 3 histology. Results A total of 26,967 women were identified. In a multivariable model, uterine RF strongly influenced survival but nodal disease was a more important negative prognostic factor. Five-year overall survival was 68% (95% confidence interval [CI], 6372%) for group 1 (node positive/no RF) vs 69% (95% CI, 6672%) for group 5 (node negative/multiple RF). Fiveyear survival was lower for nodepositive patients with RF (58%; 95% CI, 5461%) than nodepositive patients without RF (68%; 95% CI, 6372%). Conclusion Uterine RF strongly influenced survival both in the presence and absence of nodal metastasis.