Session Item

To report the clinical outcomes of uterine body cancers in South Indian population. The primary outcome of our study was overall survival (OS). The secondary outcomes were disease free survival (DFS), patterns of recurrence, toxicities of radiation treatment and the association of patient, disease and treatment characteristics with survival and recurrence.

Records of the patients diagnosed as malignancy in uterus treated from January 2013 to December 2017 were retrieved after Institute Ethics Committee approval. Demographic, surgical, histopathology and adjuvant treatment details were retrieved. Patients of endometrial adenocarcinoma were stratified according to ESMO-ESGO-ESTRO consensus for analysis and overall outcomes irrespective of histology were also analyzed. For the survival analysis, Kaplan-Meier survival estimator was used. Cox regression was used to test the significance of association of factors with outcomes in terms of hazard ratio.

178 patient records were retrieved. The median follow up of all patients was 30 months (0.5 to 81 months). The median age of the population was 55 years. Most common histology was endometrioid type of adenocarcinoma (89%), sarcomas comprised only 4%. 158 patients had undergone surgery, among which nodal regions addressed for 77 patients by either pelvic lymph node dissection (PLND) or para-aortic nodal dissection or both. Radiation therapy was delivered to 87 patients among which 72 patients received adjuvant radiation, 7 patients received preoperative radiation and 8 patients received radical radiation in view of their medical comorbidities. The mean OS of all patients was 68 months (n=178), median was not reached. 5-year OS was 79 %. Median survival was not reached for stage I, 40 months for stage II, 71 months for stage III and 8 months for stage IV. 5-year OS rates observed in low, intermediate, high- intermediate and high risk were 91%, 88%, 75% and 81.5% respectively. The mean DFS was 65 months, median not reached. The 5 year DFS was 76 %. The 5 year DFS rates observed were 82%, 95%, 80% and 81.5% for low, intermediate, high intermediate and high risk respectively. Univariate analysis using cox regression showed increase in hazard for death in case of node positivity, HR-3.96 (p-0.033). The hazard ratio for disease recurrence was 0.35 (p-0.042) in patients who had received adjuvant radiation therapy. No other factors had any significant impact on death or disease recurrence. Toxicities details were found inadequate to report.

The survival outcomes in terms of disease free survival and overall survival were comparable with other Indian and Western data reported in the published literature. Based on ESMO-ESGO-ESTRO consensus risk stratification, we had reported better survival rates in the low and intermediate risk groups which is also comparable with other reports from India.