Adjuvant chemotherapy for peritoneal cytology-positive stage IA endometrial cancer

Purpose: This study aimed at evaluating the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. Methods We retrospectively analyzed the data of patients with stage I A endometrial cancer admitted in our hospital between 2005 and 2015. Results Among 989 patients with stage IA endometrial cancer who underwent peritoneal cytology, 135 (13.7 %) had PPC. In multivariate analysis, BMI ≥ 25 kg/m 2 , grade 2 cancer, type II cancer, muscle invasion, and PPC were extracted as independent risk factors for recurrence in stage IA patients. In addition, type II cancer was identified as an independent risk factor in stage IA patients with PPC. There was no significant difference in the 5-year relapse-free survival rate in stage IA patients with PPC who received adjuvant chemotherapy when compared those who did not receive chemotherapy (p = 0.78). Similarly, the difference in the 5–year recurrence free survival rate between the two groups was not significant in patients with type II cancers (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in stage IA patients with PPC and type II was very low (66.7%). Conclusions PPC was an independent risk factor for recurrence in stage IA endometrial cancer. Adjuvant chemotherapy did not influence the relapse-free survival rate in patients with stage IA endometrial cancer with PPC. Therefore, it is necessary to investigate adjuvant chemotherapy for early endometrial cancer patients with risk factors for recurrence, especially those with multiple factors.