Clinicopathological analysis of mixed endometrial carcinomas: clinical relevance of different neoplastic components

Rossi, Esther Diana; Bizzarro, Tommaso; Monterossi, Giorgia; Inzani, Frediano; Fanfani, Francesco; Scambia, Giovanni; Zannoni, Gian Franco

doi:10.1016/j.humpath.2016.12.015

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…It has been demonstrated that the prognosis gets worse even in the existence of very small amounts of type 2 components in stage 1 endometrial cancer and should be considered as high grade 17 . In addition to studies showing that the prognosis for the presence of a serous component is similar to pure serous carcinomas 8,18 , there are studies showing that prognosis of the MECs are better than that of pure serous carcinomas [14][15][16]19,20 . Rossi et al 20 drew attention to the high grade of endometrioid component for MEC in their study and suggested that they were likely to be considered more as pure type II carcinomas than MEC.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to studies showing that the prognosis for the presence of a serous component is similar to pure serous carcinomas 8,18 , there are studies showing that prognosis of the MECs are better than that of pure serous carcinomas [14][15][16]19,20 . Rossi et al 20 drew attention to the high grade of endometrioid component for MEC in their study and suggested that they were likely to be considered more as pure type II carcinomas than MEC. Coenegrachts et al 21 compared clinical results of 23 patients having MEC (serous and endometrioid) with pure SC and EC and they reported that MECs were molecularly ambiguous and outcome of the MECs intermediate between that of patients with pure endometrioid and pure SC.…”

Section: Discussionmentioning

confidence: 99%

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Miks endometriyal karsinomun klinik ve patolojik özelliklerinin tersiyer bir merkezde değerlendirilmesi

Sucu

Geckil

Akçabay

et al. 2021

Cukurova Medical Journal

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The aim of this study was to evaluate the clinical and pathological characteristics of mixed endometrial carcinoma (MEC). Materials and Methods: The clinical and pathological records of the 29 MEC patients, who were operated on and regularly followed up in the clinic between January 2000 and December 2019, were reviewed. Clinicpathologic features and survival in the MEC group (n=29) were compared to pure serous (n=42) and pure clear cell adenocarcinomas (n=13). Clinical features, operation characteristics, pathological findings, myometrial invasion degree (MI), lymph node involvement (LNI), lymphovascular space invasion (LVSI), adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Results: Eighteen of the cases had endometrioid + serous, 7 had endometrioid + clear, 3 had endometrioid + serous, and 1 had clear + serous histopathology. Laparoscopic surgery was performed in 8 of the cases (27.6%) in the mixed group. Stage, the rate of LVSI, LNI, MI ≥50%, and omental metastasis were similar among the groups. There were no significant differences in the rates of receiving adjuvant therapy among the groups. Overall survive (OS) was similar among the groups. Conclusion: MECs are tumors that can be difficult to diagnose and manage. There was no difference between MEC and pure serous carcinoma (SC) and pure clear cell carcinoma (CC) in terms of clinicopathological features and prognosis. In addition to histopathological features, revealing and evaluating their molecular properties will help us to better understand this group of tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Miks endometriyal karsinomun klinik ve patolojik özelliklerinin tersiyer bir merkezde değerlendirilmesi

Sucu

Geckil

Akçabay

et al. 2021

Cukurova Medical Journal

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“…Mixed histology is very common in type II endometrial cancer 26,27 . Overall survival was worse in pure serous histology, compared with mixed histology.…”

Section: Discussionmentioning

confidence: 99%

“…It was interesting to know that even those with microscopic disease upon presentation had a poor prognosis similar to those with gross disease. Mixed histology is very common in type II endometrial cancer 26,27 . Overall survival was worse in pure serous histology, compared with mixed histology.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the outcome of patients with stage IV uterine serous carcinoma mimicking ovarian cancer

Al-Aker

Sanday

Nicklin

2019

Preprint

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Objectives: To identify clinicopathological factors that might influence survival in patients with stage IV uterine serous carcinoma, and to compare survival outcomes in patients with stage IV uterine serous carcinoma managed with neoadjuvant chemotherapy followed by interval cytoreduction (with or without adjuvant chemotherapy), primary cytoreductive surgery followed by adjuvant chemotherapy. Methods: A retrospective cohort study of all patients with stage IV Uterine serous carcinoma treated between 2005 and 2015 within a regional cancer centre. Progression-free and overall survival rates were calculated using the Kaplan Meier method. Results: Of 50 women with stage IV uterine serous carcinoma who met inclusion criteria, 37 underwent primary cytoreductive surgery, nine received neoadjuvant chemotherapy with planned interval cytoreductive surgery and four received palliative care only. A pre-treatment diagnosis of stage IV uterine serous carcinoma was made for only 45.9% of the primary cytoreductive surgery group and 56.6% of the neoadjuvant chemotherapy group, with advanced ovarian cancer the most common preoperative misdiagnosis. Median follow up was 19 months. Median overall survival was 27 months for the primary cytoreductive surgery group, 20 months for the neoadjuvant chemotherapy group and two months for the palliative care group. Optimal cytoreduction was achieved in 67.6% of the primary cytoreductive surgery group and 87.5% of the neoadjuvant chemotherapy group who underwent interval cytoreduction. Optimal cytoreduction was associated with improvement in overall survival, compared with suboptimal cytoreduction (36 versus 15 months; P=0.16). Adjuvant chemotherapy was associated with significantly higher overall survival compared with no adjuvant chemotherapy (36 versus four months; P<0.05). Median overall survival was 16 months for those with pure uterine serous carcinoma (n=40), compared with 32 months for those with mixed histopathology (n=10). Conclusion: Stage IV uterine serous carcinoma can mimic advanced ovarian cancer. It carries a poor prognosis, which is worse for pure uterine serous carcinoma than for mixed-type endometrial adenocarcinoma. Neoadjuvant chemotherapy followed by interval cytoreduction and adjuvant chemotherapy seems to be a safe option, with an increased rate of optimal cytoreduction and comparable overall survival, compared with primary cytoreductive surgery. Adjuvant chemotherapy significantly improves survival in all groups.

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“…They have a strong propensity to lymph node metastasis, as well as spreading and implanting into areas such as adnexa and peritoneum. While CCC commonly metastasizes into lymph nodes, EEC3 metastasizes first to pelvic organs and para-aortic lymph nodes (5). High-grade EC comprises only about 25–30% of all EC cases, but accounts for 70–75% of EC-related mortality (7).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of HER2/neu Expression in High-Grade Endometrial Carcinoma and Its Clinicopathological Correlation

et al. 2019

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Background & Objective: Endometrial carcinoma (EC) has been traditionally classified into two distinct categories of low-grade and high-grade. Type I (low grade) EC, which constitutes the majority of cases, is linked to estrogen-related molecular pathways. But type II (high-grade) EC accounts for 10-20% of cases and behaves in an aggressive way. Pathologic and biological features of type II EC have not been fully elucidated yet. Several investigations have demonstrated HER2/neu expression and amplification in type II EC, especially papillary serous carcinoma (PSC).This study assessed HER2/neu expression in high-grade EC as well as its association with other clinical and histopathological prognostic factors. Methods: In this cross-sectional study, we performed HER2/neu immunohistochemical (IHC) staining in 37 high-grade EC cases with histological diagnostic categories of PSC (n=23), clear cell carcinoma (CCC) (n=9), and carcinosarcoma with high-grade carcinomatous component (PSC, CCC, grade 3 endometrioid carcinoma, or unclassified high-grade adenocarcinoma) (n=5). All patients were followed for 2-9 years in order to evaluate their disease-free survival (DFS) and overall survival (OS) during study period (2005-2014). Results: HER2/neu IHC staining was positive in 12 patients (32.4%) including 8/23 (34.8%) PSC, 2/9 (22.2%) CCC, and 2/5 (40%) carcinosarcoma cases. There was no statistically significant difference between HER2/neu expression and DFS or OS of the patients (P>0.05). Conclusion: We observed that HER2/neu is expressed in one-third of high-grade ECs. This ancillary test is supportive in follow-up of patients with high-grade ECs.

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Clinicopathological analysis of mixed endometrial carcinomas: clinical relevance of different neoplastic components

Cited by 10 publications

References 21 publications

Miks endometriyal karsinomun klinik ve patolojik özelliklerinin tersiyer bir merkezde değerlendirilmesi

Miks endometriyal karsinomun klinik ve patolojik özelliklerinin tersiyer bir merkezde değerlendirilmesi

Analysis of the outcome of patients with stage IV uterine serous carcinoma mimicking ovarian cancer

Evaluation of HER2/neu Expression in High-Grade Endometrial Carcinoma and Its Clinicopathological Correlation

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