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Lower uterine segment involvement is associated with adverse outcome in patients with stage I endometroid endometrial cancer: Results of a multicenter study
European Journal of Surgical Oncology, 06/29/09

Gemer O et al. - In patients with apparent stage I endometroid endometrial cancer, the presence of lower uterine segment involvement (LUSI) is a poor prognostic factor, associated with a significantly higher risk of distal recurrence and death.

• Aim was to quantify the relative risk associated with LUSI on outcome measures in pts with apparent stage I endometroid endometrial cancer
• 769 consecutive pts who underwent surgery in 5 gynecological oncology centers in Israel
• 138 pts with and 631 w/o LUSI were followed for a median time of 51 mo
• Local recurrence, recurrence-free and overall survival were compared between the two groups

• LUSI was associated with grade 3 tumor, deep myometrial invasion, and presence of lymphvascular space involvement
• There were 22 cases of local recurrences, 40 of distal recurrences and 80 pts died
• Univariate survival analysis: pts with LUSI had lower regional recurrence-free survival, distant recurrence-free survival and overall survival
• A decreased overall survival in cases with LUSI was reported

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