I-HUI CHENChen, Jen-RueiJen-RueiChenChang, Ting-ChangTing-ChangChangFu, Hung-ChunHung-ChunFuLau, Hei-YuHei-YuLauChen, I. -HuiI. -HuiChenKe, Yu-MinYu-MinKeLiang, Yu-LingYu-LingLiangChiang, An-JenAn-JenChiangHuang, Chia-YenChia-YenHuangChen, Yu-ChiehYu-ChiehChenHong, Mun-KunMun-KunHongWang, Yu-ChiYu-ChiWangHuang, Kuo-FengKuo-FengHuangHsiao, Sheng-MouSheng-MouHsiaoWang, Peng-HuiPeng-HuiWang2018-09-102018-09-102016http://www.scopus.com/inward/record.url?eid=2-s2.0-84964584129&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/397249In the management of patients with advanced-stage pure endometrioid-type endometrial cancer (E-EC), such as positive lymph nodes (stage III) or stage IV, treatment options are severely limited. This article aims to investigate the outcome of women with FIGO III-IV E-EC (based on FIGO 2009 system). The retrospective cohort study, based on the Taiwanese Gynecologic Oncology Group (TGOG-2005), enrolled patients undergoing staging surgery to have a pathologically confirmed FIGO III-IV E-EC from 22-member hospitals between 1991 and 2010. This cohort included 541 patients (stage III, n=464; stage IV, n=77). Five-year overall survival (OS) was 70.4%. Median progression-free survival (PFS) was 43 months (range 0-258 months) and median OS was 52 months (range 1-258 months). Multivariate analysis showed that FIGO stage, >1/2 myometrial invasion (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.12-2.09; P=0.007), histological grade 3 (HR 2.0, 95% CI 1.47-2.75; P<0.001), and metastases of pelvic and para-aortic lymph nodes (PLN and PALN) (HR 2.75, 95% CI 1.13-6.72; P<0.001) were independent risk factors for PFS. FIGO stage, >1/2 myometrial invasion (HR 1.89, 95% CI 1.34-2.64; P<0.001), and histological grade 3 (HR 2.42, 95% CI 1.75-3.35; P<0.001) influenced OS. Complete dissection of PLN and PALN (HR 0.27, 95% CI 0.16-0.45; P<0.001, and HR 0.14, 95% CI 0.08-0.26; P<0.001) and the following paclitaxel-based therapy (HR 0.61, 95% CI 0.79-0.92; P=0.017, and HR 0.48; 95% CI 0.31-0.75; P=0.001) provided the better PFS and OS, respectively. In management of women with FIGO III-V E-EC, combination of complete staging surgery (complete dissection of PLN and PALN is included) and the following paclitaxel-based therapy could provide the better chance to survive. Patients with tumor >1/2 myometrial invasion and histological grade 3 are risky for disease-related mortality. ? 2016 Wolters Kluwer Health, Inc. All rights reserved.[SDGs]SDG3paclitaxel; platinum derivative; antineoplastic agent; adjuvant therapy; adult; Article; cancer adjuvant therapy; cancer mortality; cancer prognosis; cancer radiotherapy; cancer staging; cancer surgery; cancer survival; cohort analysis; endometrioid carcinoma; endometrium cancer; female; follow up; human; hysterectomy; lymph node dissection; lymph node metastasis; major clinical study; myometrium; overall survival; para aortic lymph node metastasis; paraaortic lymph node; pelvis cancer; priority journal; progression free survival; retrospective study; salpingooophorectomy; treatment outcome; tumor invasion; uterus surgery; adjuvant chemotherapy; cancer grading; Carcinoma, Endometrioid; Endometrial Neoplasms; lymph node metastasis; middle aged; mortality; pathology; procedures; proportional hazards model; risk factor; survival analysis; Taiwan; Adult; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Endometrioid; Chemotherapy, Adjuvant; Endometrial Neoplasms; Female; Humans; Lymphatic Metastasis; Middle Aged; Neoplasm Grading; Neoplasm Staging; Proportional Hazards Models; Retrospective Studies; Risk Factors; Survival Analysis; Taiwanjournal article10.1097/MD.0000000000003330