3786 - Prognostic Factors in Stage I-II High-Risk Endometrial Cancer: Including the Role of Inflammatory Marker
Presenter(s)
M. K. Ko1, J. H. Hong1, and Y. S. Kim2; 1Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South), 2Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South)
Purpose/Objective(s): Endometrial cancer (EC) with FIGO stage I–II high-grade histology, including grade 3 endometrioid and non-endometrioid subtypes, remains heterogeneous in prognosis despite standard adjuvant therapy. This study evaluated prognostic factors in stage I–II high-risk endometrial cancer, with an exploratory assessment of preoperative inflammatory markers.
Materials/Methods: We retrospectively analyzed 118 patients with FIGO 2009 stage I–II high-risk EC (grade 3 endometrioid and non-endometrioid) treated between 2008 and 2023. Adjuvant therapy included radiotherapy (RT), chemotherapy (CT), or combined modality. Preoperative inflammatory markers (NLR, PLR, SII, HALP) were collected within 3–4 weeks before surgery. Survival outcomes were evaluated by Kaplan–Meier method, and prognostic factors were identified using Cox proportional hazards regression.
Results: During a median follow-up of 59.5 months, 32 progressions and 17 deaths occurred. The 5-year PFS and OS were 65.2% and 81.9%. On univariate analysis, non-endometrioid histology predicted inferior OS (p<0.001), and receipt of adjuvant therapy significantly improved both PFS (p=0.007) and OS (p=0.002), while inflammatory markers showed no significant associations. On multivariate analysis, non-endometrioid histology remained independent predictor of worse OS (HR 15.57, p=0.001), and higher NLR was independently associated with worse PFS (HR 2.44, p=0.011).
Conclusion: In stage I–II high-risk endometrial cancer, histologic subtype and adjuvant therapy were major prognostic factors, with survival benefit observed for adjuvant treatment. Exploratory analyses suggested that elevated NLR may provide additional prognostic information.