Analysis of the frequency of endometral cancer recurrence in stage I-II

Abstract

Introduction. An increase in the incidence of endometrial cancer requires not only early detection of this disease, but also appropriate treatment, taking into account clinical, morphological, molecular-genetic prognostic factors and the frequency of recurrences (fig.1,2). Purpose. The aim of this study was to study the morphological factors of the prognosis and the characteristics of endometrial cancer recurrence in stage I-II, with the introduction of a classification based on the molecular characteristics of tumors. Material and methods. The study represents a complex, prospective analysis of clinicalmorphological data and recurrence rates in 200 patients with stage I-II who were treated at the Department of Gynecological Oncology of the Institute of Oncology of the Republic of Moldova for 2015-2018, based on ESGO risk criteria (fig.3). Results. Free interval before recurrence was 24 months. In 11 patients, recurrence developed up to 24 months and in 9 to 60 months. An indicator of the aggressiveness of the tumor process is cell proliferation, which can be assessed using the percentage of Ki-67 positive nuclei(fig.5). A high percentage of Ki-67 is associated with an unfavorable prognosis of the EC. When analyzing the expression index Ki-67, it was found that in the low-risk group of patients with EC, the Ki-67 index was 14%, from the group with intermediate risk, the expression level was 25.5%, from the high risk group (fig.4). Conclusions. In the first three years of observation, recurrences of the underlying disease were observed in the general group of patients examined with EC in stage III. Of the 200 patients with stage I-II, recurrences and metastases were detected in 20 (40%) patients. Clarification of the risk group during the initial examination and immediately after the surgical treatment of patients with endometrial cancer using clinical, morphological and immunohistochemical methods and our results make it reasonable to monitor EC at early stages even in the low-risk group and to search for new molecular genetic prognostic factors.