Prognostic factors in stages II/III/IV and stages III/IV endometrioid and serous adenocarcinoma of the endometrium

Abstract

Aims To explore and to compare the outcome of patients diagnosed with stage II/III/IV and stage III/IV endometrioid adenocarcinoma (EAC) with their serous carcinoma (USC) counterparts. Materials and methods A total of 107 patients (73 EAC and 34 USC) were evaluated. For statistical analysis, the following baseline variables were considered for their prognostic value: the patient’s age at presentation, the tumor size, the depth of myometrial invasion (MI), the lympho-vascular involvement (LVI) and the USC and the EAC subtypes (considered as binary variables). Disease free survival (DFS), death of disease (DOD) and overall survival (OS) were assessed using univariate and multiple Cox proportional hazards models. Results In univariate analysis, USC tends to recur more frequently than EAC (p = 0.004), a finding that disappeared in multivariate analysis. Furthermore, tumor histology had no significance in predicting the tumor outcomes. Among all of the prognostic factors and after adjusting for the aforementioned variables, MI ≥50% was the only independent factor in predicting DOD in stages II/III/IV (p = 0.009) and in stages III/IV (p = 0.004). MI was also an independent predictive factor for OS (p = 0.02) and early recurrences in stages III/IV. LVI was the only independent factor in predicting recurrences (p = 0.004) in stages II/III/IV but not in stages III/IV. Conclusion Based on our study, tumor histology was not a significant factor in predicting disease outcome in stages II/III/IV and II/IV. Despite our limited sample size, we believe that our findings provide meaningful insights into the clinical study of endometrial cancer patients which in turn warrants further investigation.

Immunohistochemical characterization of endometrial carcinomas: Endometrioid, serous and clear cell adenocarcinomas in association with genetic analysis

“…However, continuous debates remain regarding whether G3 EMA belongs to type I or type II. [12][13][14][15][16][17][18] Some studies have reported no significant difference in the prognosis between SEA and G3 EMA, 15,17,19,20 while other reports have mentioned that SEA is poorer in the prognosis than for G3 EMA. 11,17,21 CCA is considered to be a clinicopathologically intermediate entity between EMA and SEA.…”

ER+/PR+/TFF3+/IMP3− immunoprofile distinguishes endometrioid from serous and clear cell carcinomas of the endometrium: a study of 401 cases

“…Even though EAC G3 belongs to the high‐grade group of endometrial carcinomas, it is documented as having a better survival rate than USC . However, recent reports concluded that there is no difference in outcome between the two types when they are detected in early‐stage and in late‐stage disease . Until further analysis is performed on these data, differentiating EAC from USC and CCC is most important for patient treatment and prognosis.…”

“…[9][10][11][12][13] However, recent reports concluded that there is no difference in outcome between the two types when they are detected in early-stage and in late-stage disease. 14,15 Until further analysis is performed on these data, differentiating EAC from USC and CCC is most important for patient treatment and prognosis. It is also imperative to confirm an accurate diagnosis not only on hysterectomy specimens, in order to plan treatment, but also on biopsy/curetting specimens, which, in turn, might have an impact on patient management intraoperatively.…”

Uterine serous carcinoma: key advances and novel treatment approaches

“…30 In an International Federation of Gynecology and Obstetrics (FIGO) annual report, stage II-IV disease was noted at presentation in 46% of women with uterine serous carcinoma compared with 21% of women with endometrioid adenocarcinoma. 30 The surgical pathologic protocol, Gynecologic Oncology Group (GOG) 210 provides a large, contemporary dataset of uterine serous carcinoma tumors removed at the time of hysterectomy with surgical staging. 31 Lymph node status remains among the most important prognostic factors in uterine serous carcinoma.…”