Characteristics and Outcome of Endometrial Carcinoma Patients Age 45 Years and Younger

Abstract

Recent reports have suggested that the pathologic features of young patients with endometrial cancer are less favorable than previously thought. We retrospectively reviewed the characteristics and outcome of young patients with endometrial cancer at our institution. A total of 457 surgically staged patients were divided in 2 groups: Group A (age < or =45 years, n = 41) and B (age >45, n = 416). Groups A and B had a similar distribution of tumor stage, grade, histology, lymphovascular invasion, synchronous ovarian primaries, and positive cytology. Although group A tumors had less myometrial invasion (MI) (p = 0.004) and were lower grade (p = 0.06), a trend to more frequent nodal involvement was seen in group A women (p = 0.09). Adverse pathologic features, in particular deep MI, were more common in group A patients older than age 40. Group A patients had a disease-free (p = 0.56) and cause-specific (p = (0.26) survival that was similar to that of group B patients. Young patients with endometrial cancer have a distribution of most pathologic features and equivalent outcome similar to that of older women. However, adverse features are not equally distributed in young women. A discordance may also exist between MI, grade, and nodal involvement.

Safety of ovarian preservation in young patients with early-stage endometrial cancer: a retrospective study and meta-analysis

“…In a large scale population-based study, the 5-year disease-specific survival was 93% in women younger than 40 years (4). Younger patients with endometrial cancer often have early-stage, low-grade tumors, which may, in part, explain the higher survival of younger patients (4)(5)(6).…”

Fertility-Preserving Treatment in Young Women with Endometrial Cancer

“…It has been suggested that endometrial carcinomas in young women are less aggressive and biologically different compared to those in older women [3][4][5][6][7][8][9][10] . Other investigators noted a similar incidence of extrauterine disease, unfavorable histologies and outcome in women aged 45 years or younger compared to older women [11][12][13] . There might be a difference in grade and myometrial invasion between younger and older patients, but all studies of women younger than 40 or 45 years have been limited by small numbers and permit few conclusions.…”

Ovarian preservation during the surgical treatment of early stage endometrial cancer: A nation-wide study conducted by the Korean Gynecologic Oncology Group

“…Essentially, the pathologic features and outcomes of young women with endometrial cancer are reported to be similar to those of older women [9,10]. Furthermore, a recent analysis of 61,314 women in the Surveillance, Epidemiology, and End Results (SEER) cancer database from 1988 to 2003 found that younger women are more likely to be diagnosed with earlier stage disease than their older counterparts, and that their overall mean survival is significantly better [4].…”