LAUSR

Objectives: Survival is often discussed in terms of five-year survival. However, conditional survival expresses the probability of survival as a function of time already survived. The purpose of this study was to investigate the impact of stage and grade on overall survival, conditional survival and relative mortality risk in women with endometrioid endometrial carcinoma (EEC). Methods: Eligible participants were diagnosed following surgery with low grade (LG)-EEC (grade 1/2) or high grade (HG)-EEC (grade 3) between 2004 and 2014 in the National Cancer Database. Survival was compared by stage with log-rank test and with multivariate Cox modeling in LG-EEC or HG-EEC. Five-year conditional survival was evaluated by stage using Kaplan-Meier method in women with LG-EEC or HG-EEC who survived 1 to 5 years after diagnosis. Standardized mortality ratio (SMR) defined as the ratio of observed to expected number of deaths was estimated based on the mortality risk of general US population matched by age and race. Results: There were 147,944 women with LG-EEC (85.9% stage I, 5.7% stage II, 7.4% stage III, 1.0% stage IV) and 25,267 with HG-EEC (57.4% stage I, 8.7% stage II, 24.7% stage III, 9.3% stage IV). Stage was an independent poor prognostic factor in LG-EEC and HG-EEC (Fig. 1A). Adjusted HR was 1.67, 2.88 and 7.25 for stage II, III and IV vs. I LG-EEC and 1.78, 3.20 and 6.73 for stage II, III and IV vs I HG-EEC, respectively (P Download : Download high-res image (302KB) Download : Download full-size image Conclusions: Prognosis for EEC improves over time in almost all groups with the most significant improvement in women with advanced stage and high-grade disease. Conditional survival provides clinicians and patients with an informative incremental recalibration in prognosis during the milestones of survivorship advancing shared decision-making across the continuum of care regarding treatment and surveillance.