Abstract

Between January 1986 and January 1996, 324 cases with carcinoma of the endometrium who received postoperative radiotherapy were evaluated retrospectively. The age range was between 35-83 (median 56). Histologically 83.3% were adenocarcinoma, 5.9% adenosquamous carcinoma, 5.6% clear celi carcinoma and 5.2% serous papillary adenocarcinoma. The distribution according to stages for Stage 1,11,111 and IV disease were 62.7%, 18.5%, 16.0% and 2.8% respectively. External radiotherapy (RT) was given through pelvic portals with 1.8-2 Gy daily fractions to a total of 45-66 Gy (median 54Gy) and 54.3% of the patients were applied intracavitary RT. Local recurrence, distant metastasis and grade III-IV late morbidity rates were 8.0%, 19.6% and 3.6% respectively. Five-year overall, disease free and recurrence-free survival rates were 78.2%, 74.7% and 93.7% respectively. In univariate analysis the prognostic factors which influence disease-free survival rate were histologic grade (p=0.005), histologic type (p < 0.0001), stage (p=0.001), myometrial invasion (p=0.002), peritoneal cytology (p=0.003) and lymphovascular invasion (p=0.002), peritoneal cytology (p=0.003) and lymphovascular invasion (p=0.039) while the prognostic factors influencing the local control rate were high histologic grade (p=0.043), advanced stage (p=0.024), myometrial invasion more than 1/2 (p=0.005), positive peritoneal cytology (p=0.032). In multivariate analysis using Cox's regression model the prognostic factors which influence the disease-free survival rate were histologic grade (p=0.003) and histologic type (p=0.012). The factor which influence the local control rate was histologic grade (p=0.044).