Abstract
Background: The effect of tumor size on endometrial cancer prognosis and the treatment precision is a challenging issue. This study aimed at assessing the predictive impact of tumor size on endometrial carcinoma aggressiveness parameters and patients' survival.
Methods: 94 patients with surgically treated endometrial cancer in the Radiation Oncology Department of Imam Hossein Hospital, Tehran, Iran between 2010 and 2020 were included for retrospective review of their clinicopathological information and follow-up data. Categorical variables were compared using Chi-squared and Fisher’s exact test, and continuous variables were compared using non-parametric Mann-Whitney U and Kruskal-Wallis tests. Actuarial overall survival and recurrence-free survival were calculated using Kaplan–Meier method.
Results: Patients with tumor size 4 cm and more had higher rates of lymphovascular invasion (LVI) compared to smaller tumors (51.7% vs 13.8%, P<0.001). Additionally, there was a significant correlation between tumor size and FIGO stage (p=0.031). Patients with Carcinosarcoma pathology had marked larger tumor diameter (mean:6.7cm ±2.4), compared with Endometroid (mean:3.9cm ±1.6) (P<001) and Serous adenocarcinoma (mean:2cm ±0.79) (P<001). All seven patients with tumor size 4 cm and more who experienced recurrence in their follow up, had one of the other significant risk factors including high tumor stage(>I), LVI or carcinosarcoma histology. There was not a significant correlation between tumor size and recurrence (p:0.272), overall and recurrence free survival (P:0.754, P:0.169 Respectively).
Conclusion: Although tumor size correlates with other poor prognostic factors of endometrial carcinoma, it is not an independent variable for patients' survival and tumor recurrence. Patients with high tumor size, who experience recurrence, have some other adverse features.
Keywords
Endometrial cancer, Tumor size, Prognosis