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June 10, 2026Open Access

Prognostic outcomes in patients of low-grade endometrioid carcinoma confined to the adnexa who received no adjuvant therapy: a retrospective analysis

Key Points

This study evaluates the prognosis of low-grade endometrioid carcinoma confined to the adnexa without receiving adjuvant therapy.
Retrospective analysis of 439 low-grade endometrioid carcinoma patients and 739 aggressive-histotype patients from SEER database.
Patients were categorized by treatment types including no adjuvant therapy, using Kaplan-Meier analysis for survival comparison.
Log-rank tests evaluated differences in prognostic outcomes.
5-year overall survival for low-grade endometrioid carcinoma was 82.4% compared to 54.3% for aggressive-histotype, p<0.05.
5-year overall survival in the no-adjuvant therapy group was 70.6%, lower than chemotherapy-only (84.6%) and combined therapy (88.7%).
Even without adjuvant therapy, low-grade endometrioid carcinoma had better survival (70.6%) than aggressive-histotype (34.3%), p<0.05.

Abstract

Objective:The International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system for endometrial cancer (EC) recommends exempting stage IA3 patients from adjuvant therapy.Therefore, this study aims to evaluate the prognosis of low-grade endometrioid carcinoma (LGEC) confined to the adnexa without adjuvant treatment.Methods: A retrospective analysis of 439 LGEC with adnexal involvement and 739 aggressivehistotype EC with adnexal involvement patients from the Surveillance, Epidemiology, and End Results database was conducted.Patients were grouped by treatment received: radiotherapy only, chemotherapy only, combined therapy, and no adjuvant therapy.Kaplan-Meier analysis compared prognostic outcomes, and survival differences were evaluated using the log-rank test. Results:The 5-year overall survival (OS) for adnexal-involved, LGEC patients was significantly higher than that for adnexal-involved, aggressive-histotype EC patients (82.4% vs. 54.3%,p<0.05).Among LGEC patients, those in the no-adjuvant therapy group (n=87, 19.8%) had a 5-year OS of 70.6%, which was lower than that of the chemotherapy-only group (84.6%), the combined radiotherapy and chemotherapy group (88.7%), and the radiotherapyonly group (75.5%), with statistically significant differences among the groups (p<0.05).Even within the no-adjuvant therapy subgroup, LGEC with adnexal involvement patients demonstrated markedly better 5-year OS compared to their aggressive-histotype EC with adnexal involvement counterparts (70.6% vs. 34.3%,p<0.05). Conclusion:The IA3 substage newly introduced in the 2023 FIGO system provides clear prognostic stratification.While a 5-year OS of 70.6% was observed in adnexal-involved, LGEC patients without adjuvant therapy, prognosis varies by treatment, highlighting the need for individualized postoperative strategies based on pathological and clinical factors.

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