Determination of prognostic factors in early stage endometrium cancer

Objective: The objective of this study is to investigate the prognostic factors associated with early stage endometrial cancer. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with early stage (Stage Ia, Ib, and II) endometrial cancer who underwent surgery and follow-up at the Obstetrics and Gynecology Department of İnönü University between January 2011 and December 2022. Results: The median age of the patients enrolled in the study was 57 (ranging from 34 to 86). Among the patients, 181 (75.10%) were classified as stage Ia, 47 (19.50%) as stage Ib, and 13 (5.40%) as stage II endometrial cancer. Several factors, including gravida, parity, serum CA-125 levels, and histological grade, were significantly higher in the patient group without mortality (p=0.011, p=0.047, p<0.001, and p=0.029, respectively). Univariate regression analysis revealed that increased serum CA-125 levels [Hazard ratio (HR) 1.009; 95% Confidence Interval (CI) 1.003-1.016; p=0.004)], higher disease stage (HR2.69; 95%CI 1.009-6.722; p=0.048), and elevated histological grade (HR4.85; 95%CI 1.35-17.40; p=0.015) were associated with overall survival (OS). Multivariate analysis demonstrated that histological grade independently predicted both OS and disease-free survival (DFS) (HR5.942; 95%CI 1.593-22.158; p=0.008; HR4.830; 95%CI 1,487-15,687; p=0.009), respectively. Conclusion: This study highlights the independent predictive value of histological tumor grade for OS and DFS in early stage endometrial cancer patients. These findings emphasize the importance of performing comprehensive surgical staging in cases where a high histological tumor grade is detected during intraoperative frozen section analysis, ensuring a comprehensive assessment for early-stage endometrial cancer. Keywords: CA-125 Antigen, Disease-free survival (DFS), Endometrial cancer, Survival Analysis, Prognosis