Objective. The aim of this study is to look at possible differences in outcome between serosa and adnexal involvement stage IIIA endometrial carcinoma. Methods. 67 patients with stage IIIA endometrial carcinoma were included, 46 with adnexal involvement and 21 with serosa. A central histopathological review was performed. Results. The 7-year locoregional failure rate was (LRFR) 2.2% for adnexal involvement and 16.0% for involvement of the serosa ( ). The 7-year distant metastasis-free survival was 72.7% for adnexal involvement and 58.7% for serosa ( ). The 7-year disease-specific survival (DSS) was 71.8% for patients with adnexal involvement and 75.4% for patients with serosa. Conclusion. Endometrial carcinoma stage IIIA with involvement of the adnexa or serosa showed to have a comparable disease-specific survival. Locoregional control was worse for serosa involvement compared to adnexa. 1. Introduction The majority of patients with endometrial cancer are diagnosed without evidence of extra uterine spread, leading to only 10–15% of the patients with stage III disease [1]. In 1988, the International Federation of Gynecology and Obstetrics (FIGO) mandated the staging of endometrial cancer be changed from a clinical staging system to a surgical staging system because of the inaccuracies of the former. Staging of the disease is since then based on pathological criteria after initial resection and evaluation. According to FIGO 1997 stage IIIA endometrial carcinoma is defined as tumor involvement either as direct extension or metastasis to serosa, parametria, adnexa, and/or cancer cells in peritoneal washings [2]. Due to this broad definition, patients with stage IIIA form a heterogeneous group. Different types of tumor involvement within this heterogeneous group might have impact on prognostic factors and outcome. Due to the heterogeneity of the tumor characteristics in this stage and the low incidence only small series have been published. FIGO has recently updated the staging system with a significant change to the staging of endometrial carcinoma stage IIIA. The presence of abnormal cells in peritoneal washings no longer affects staging. This resulted in a less heterogeneous stage IIIA. We had the opportunity to do a multi-institutional study on stage IIIA with isolated involvement of the serosa and adnexa. The aim of this study is to reveal possible differences in outcome between isolated serosa and adnexal involvement and determine possible prognostic factors in two homogeneous groups of patients with stage IIIA endometrial carcinoma based solely on
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