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October 1984

Comorbid and Clinical Determinants of Prognosis in Endometrial Cancer

Author Affiliations

From the Departments of Medicine (Ms Wells, and Drs Stoller, Feinstein, and Horwitz) and Epidemiology (Drs Feinstein and Horwitz), and the Clinical Epidemiology Unit and Robert Wood Johnson Clinical Scholars Program (Drs Feinstein and Horwitz), Yale University School of Medicine, New Haven, Conn, and the Cooperative Studies Program Coordinating Center, Veterans Administration Hospital, West Haven, Conn (Dr Feinstein).

Arch Intern Med. 1984;144(10):2004-2009. doi:10.1001/archinte.1984.04400010120020

• In cancers of the lung, larynx, rectum, and breast, the patients' initial clinical manifestations and comorbid diseases have shown important prognostic distinctions that are not evident in the customary systems of anatomic staging. This study was done to see whether the same phenomena occurred for cancer of the endometrium. In 142 consecutive cases of endometrial carcinoma, strikingly high five-year survival rates were found in women who had no symptoms attributable to the cancer or whose only symptoms might have been caused either by concomitant uterine or cervical disease or by replacement estrogen therapy. A distinct decline in survival was associated with systemic symptoms and with major comorbid ailments. Estimation of prognosis and evaluation of therapy can be improved with a new composite staging system, formed by combining the new clinical categories and the standard morphologic stages of the International Federation of Gynecology and Obstetrics (FIGO) system.

(Arch Intern Med 1984;144:2004-2009)