Prognostic significance of tumor grade in early-stage endometrioid endometrial cancer

Abstract

Aim: Although tumor grade has no impact on endometrial cancer stage, it carries prognostic and therapeutic importance. Surgicalmanagement and adjuvant treatment following surgery in certain patients depends on a number of factors including tumor grade.Although grade 3 tumors are included in the high-intermediate risk group, there are data demonstrating that there is a slight differencein survival between patients with grade 1 and 2 tumors in early-stage disease. In this study, we aimed to investigate the associationof grade with clinicopathological characteristics, recurrence-free and disease-specific survival in patients treated at our clinic anddiagnosed with endometrioid endometrial cancer.Material and Methods: 279 patients with early FIGO Stage endometrioid endometrial cancer treated between 2009-2018 in aUniversity hospital were included in the study. The associations between tumor grade with stage, lymphovascular space invasion(LVSI), myometrial invasion, tumor size, and survival were analyzed.Results: LVSI, ≥50% myometrial invasion, advanced stage and > 2 cm tumor size were significantly higher in grade 3 tumors comparedto patients with grade 1 tumors. Recurrence-free and disease-specific survival were significantly lower in patients with grade 2 and3 tumors compared to patients with grade 1 tumors. In multivariate analysis of RFS and DSS, tumor grade, LVSI and stage wereindependent prognostic factors.Conclusion: According to this study, grade 2 tumors may not differ significantly from grade 3 tumors in terms of survival. Therefore,due to the potential adverse prognosis associated with grade 2 and 3 tumors, vigilance for recurrence is warranted.