Endometrial Papillary Adenocarcinomas

Chen, Jane L.; Trost, Donald C.; Wilkinson, Edward J.

doi:10.1097/00004347-198512000-00001

Cited by 66 publications

(16 citation statements)

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“…The lower average age of the patients with ECSP than that of those with SPC and the frequent association of the former tumor with adjacent endometrial hyperplasia are consistent with its belonging in the category of carcinomas of the endometrium that are typically estrogen-related and have a much better prognosis than carcinomas that are not estrogen-related and occur in an older age group. The average ages of patients with ECSP and SPC did not differ significantly (p=0.23), however; the average age of the former patients was intermediate between that of the patients with SPC and that of those with EC in general (as shown in our material and in the literature) [8,10,11,15,18,21,22]. The overall 5-year disease-free survival rates in our series for ECSP and SPC were 84% (95% CI: 0.68-1) and 33% (95%CI: 0.10-0.56) respectively.…”

Section: Discussionsupporting

confidence: 63%

“…In 1981 Lauchlan [5] introduced the term "tubal (serous) carcinoma of the endometrium" for these tumors, and one year later, Hendrickson et al [6] delineated the entity 'uterine papillary serous carcinoma," showing that it was much more aggressive clinically than the more common endometrioid carcinoma (EC) of the uterus. Subsequently, numerous studies have confirmed the morphologic and clinical differences between the two tumors [7][8][9][10][11][12][13][14][15][16]. It has become widely recognized in recent years that some ECs contain large villous papillae with fibrovascular cores lined by well-differentiated columnar epithelial cells similar to those of grade 1 nonvilloglandular endometrioid adenocarcinoma (NVGEC) [10,17,18].…”

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confidence: 99%

“…It has become widely recognized in recent years that some ECs contain large villous papillae with fibrovascular cores lined by well-differentiated columnar epithelial cells similar to those of grade 1 nonvilloglandular endometrioid adenocarcinoma (NVGEC) [10,17,18]. The behavior of these villoglandular endometrioid carcinomas (VGEC) has been somewhat controversial [10,12,19,20], but Zaino et al [21], in the largest reported study of them, which was sponsored by the Gynecologic Oncology Group, demonstrated that they have a prognosis similar to that of NVGEC.…”

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confidence: 99%

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Uterine Endometrioid Carcinoma with Small Nonvillous Papillae: An Analysis of 26 Cases of a Favorable-Prognosis Tumor To Be Distinguished from Serous Carcinoma

Murray

Young²,

Scully

2000

Int J Surg Pathol

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We have encountered a number of endometrioid carcinomas with small papillary buds lacking fibrovascular cores that could be confused with the small cellular papillae of serous papillary carcinoma (SPC). We have designated these tumors "endometrioid carcinoma with small nonvillous papillae" (ECSP). Because they have not been investigated previously we analyzed 26 examples and compared their features with those of 21 SPCs of the uterus. Three hundred and ninety consecutive cases of endometrial carcinoma diagnosed between January, 1989, and January, 1994, were retrieved from our hospital files; 26 (6.7%) of them, (8% of the endometrioid carcinomas) were identified as ECSP, and 21 (5.4%) as SPC. Tumors were classified as ECSP when the small papillae were present within the glands of otherwise typical endometrioid carcinoma or on the villous projections of villoglandular endometrioid carcinoma. Most of the papillae were in the form of buds of cells with ample eosinophilic cytoplasm and a low nuclear-to-cytoplasmic ratio, but some papillae had a more complex pattern. The papillae arose on a background of International Federation of Gynecology and Obstetrics (FIGO) grade 1 or 2 endometrioid carcinomas, which showed squamous differentiation in half the cases. SPCs were identified according to generally accepted criteria. The mean age of the patients with ECSP was 67 years, intermediate between that of the patients with endometrioid carcinoma lacking small nonvillous papillae (62 years) and that of the patients with SPC (71 years). Patients with ECSP more frequently presented at an earlier stage (73% stage I/II) than those with SPC (29% stage I/II). The overall 5-year survival of patients with ECSP was 84% (95%CI: 0.68-1), more than double that of patients with SPC, 33% (95%CI: 0.10-0.56). ECSP may be confused with SPC on microscopic examination but has clinical and pathological features similar to those of endometrioid carcinoma lacking small nonvillous papillae, and unlike SPC, should be treated in the same manner as the former. Int J Surg Pathol 8(4):279-289, 2000

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Section: Discussionsupporting

confidence: 63%

mentioning

confidence: 99%

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confidence: 99%

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Uterine Endometrioid Carcinoma with Small Nonvillous Papillae: An Analysis of 26 Cases of a Favorable-Prognosis Tumor To Be Distinguished from Serous Carcinoma

Murray

Young²,

Scully

2000

Int J Surg Pathol

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“…Ten percent of this morphologically heterogeneous group of cancers comprises a papillary serous histology, closely resembling ovarian papillary serous cancer (2) . Uterine papillary serous carcinoma (UPSC) is characterized by an aggressive course, with a high rate of relapse and poor prognosis relative to endometrioid adenocarcinoma (3)(4)(5)(6) . The overall 5-year survival rate is only 46% for UPSC and accounts for a disproportionate number of intraabdominal failures, and while only 6% of clinical stage I uterine cancers are UPSCs, they have been reported to constitute nearly a quarter of the stage I mortality (7) , suggesting that UPSC may have different tumorigenesis than other endometrial carcinomas.…”

mentioning

confidence: 99%

HER-2/neuoverexpression in uterine papillary serous cancers and its possible therapeutic implications

Villella

Cohen²,

Smith

et al. 2006

International Journal of Gynecological Cancer

125

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Uterine papillary serous carcinoma (UPSC) is a highly aggressive variant of endometrial cancer with features similar to high-grade ovarian cancer. Patients tend to be elderly, thin, have a high grade tumor with extensive extrauterine disease at the time of diagnosis. The transmembrane receptor encoded by the HER-2 cellular oncogene is amplified in several types of human carcinomas and provides an attractive therapeutic target. HER-2/neu, the transmembrane receptor encoded by the c-erbB2 gene, is overexpressed by immunohistochemistry in <25% of ovarian cancers and 20-30% of breast cancers, and <10% of endometrial cancer. There are prognostic and therapeutic implications associated with the overexpression of this transmembrane protein. Herceptin, a humanized murine monoclonal antibody directed against the extracellular domain of the HER-2/neu protein, is being used to treat breast cancer that overexpresses HER-2/neu. We reviewed all patients diagnosed with UPSC between 1999-2001. Twenty-six patients were identified, and 19 patients had specimens available for evaluation. We performed immunohistochemical analysis (Herceptest, Dako, Carpinteria, CA) on 19 paraffin embedded blocks of UPSC tumors looking for HER-2/neu over expression. Five out of 19 (26%) stained heavily (3+) for HER-2/neu receptor protein. Four of these five patients had advanced disease at diagnosis. Two of these patients were subsequently treated with Herceptin; one with complete response and one with stable disease based on CT scan and CA-125 findings. Targeting HER-2/neu may be beneficial for a select group of patients with UPSC. We are continuing to evaluate samples for HER-2/neu over expression by fluorescence in situ hybridization (FISH).

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“…However, the findings of the significance of villoglandular differentiation in endometrioid carcinomas are inconclusive. [9][10][11][12] In the present study, considering only clinicopathologic features, a notorious aggregation of carcinomas with early-stage disease (60% were FIGO stage I, P = .05) in villoglandular endometrioid carcinomas does not seem to support an association between papillary differentiation and aggressive behavior.…”

Section: Discussionmentioning

confidence: 61%

Clinicopathologic Features and Genetic Alterations in Endometrioid Carcinoma of the Uterus with Villoglandular Differentiation

Esteller¹,

García

Martínez-Palones

et al. 1999

Am J Clin Pathol

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A b s t r a c tUterine cancer is the fourth most frequent cancer in women, with an estimated 34,000 cases and 6,000 deaths in the United States in 1996.1 Although 78% of all uterine cancer is diagnosed while it is restricted to the uterus, 2 carcinoma of the endometrium may spread along the uterine cavity to the cervix, penetrate the uterine wall, or spread through the fallopian tubes. Once disseminated, it is as lethal as ovarian cancer. 3Tumors of the endometrioid subtype constitute about 75% of all endometrial carcinomas, 4 and 5-year survival rates for these cancers (the majority of which are confined to the uterus) have been found to exceed 80% in most studies. 5However, the remaining histologic subtypes, including the papillary serous, clear cell, undifferentiated, and squamous cell types, are associated with a significantly worse prognosis, with an overall 5-year survival of less than 30%. 5 Particularly, papillary serous carcinomas are extremely malignant. 6-8Because serous and endometrioid carcinomas differ dramatically in their clinical behavior, the characterization of papillary serous carcinoma and its distinction from papillary (villoglandular) endometrioid carcinoma was a salient finding.6 It has been frequently assumed that villoglandular endometrioid carcinomas would behave in a way similar to nonvilloglandular endometrioid carcinomas. However, few studies have focused on the villoglandular variant of endometrioid carcinomas, and the data are inconclusive. Some reports have found a behavior similar to nonvilloglandular, 9 others a more aggressive behavior, 1011 and, more recently, a higher frequency of vascular invasion, lymph node metastasis, and worse outcome when papillary differentiation is present in the invaded myometrium. 12In addition, substantial progress has been made in the molecular characterization of endometrial carcinoma, 13 and a clinicopathologic assessment of endometrial carcinoma subtypes according to genetic alterations has been proposed.

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Endometrial Papillary Adenocarcinomas

Cited by 66 publications

References 0 publications

Uterine Endometrioid Carcinoma with Small Nonvillous Papillae: An Analysis of 26 Cases of a Favorable-Prognosis Tumor To Be Distinguished from Serous Carcinoma

Uterine Endometrioid Carcinoma with Small Nonvillous Papillae: An Analysis of 26 Cases of a Favorable-Prognosis Tumor To Be Distinguished from Serous Carcinoma

HER-2/neuoverexpression in uterine papillary serous cancers and its possible therapeutic implications

Clinicopathologic Features and Genetic Alterations in Endometrioid Carcinoma of the Uterus with Villoglandular Differentiation

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