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Complete cytoreduction surgery followed by appropriate chemotherapy is a valuable option for advanced endometrial cancer. In patients with advanced endometrial cancer, complete cytoreduction with no gross residual disease is associated with superior overall survival outcome and free disease time. Also, patient with stage III endometroid endometrial cancer is associated with superior overall survival outcome and free disease time. Patient selection and accurate clinical staging are prerequisites when adopting upfront surgery strategies.The study was conducted on a group patients diagnosed to have advanced endometrial cancer FIGO stage III/IV attending at El Shatby maternity hospital from January 2020 to December 2021 to assess the effect of upfront surgery on the outcome of the disease. The patients will be diagnosed by D&C biopsy, US and CT. The procedure will be decided according to: Peritoneal cancer index and American society of anaesthesiologist (ASA) physical status. Then all the patients will receive routinely 6 cycles of chemotherapy and followed up for one year to asses recurrence, survival rate and other complication.

An observational, analytical cross-sectional study was conducted over one year and three months on 113 patients with primary type 1 endometrial carcinoma who were consecutively diagnosed by D&C and histopathology or confirmed on hysterectomy specimens. Preoperative evaluation for staging was done with ultrasound and MRI when indicated; D&C biopsy and paraffin-embedded tissues were examined for histopathological features and expression of P53 using immunohistochemical staining techniques on endometrial tissues or hysterectomy specimens, and this was done on 63 patients. Data were fed to the computer and analyzed using the IBM SPSS software package, version 20.0. (Armonk, NY: IBM Corp).This study showed that the P53 null-type pattern is also found in type 1 endometrial carcinoma and non-testing of p53 expression could result in under or overtreatment. It also revealed that p53 expression and mutant type are directly related to advanced age and a higher preoperative histology grade.

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