Prognostic value of the presence of serous endometrial intraepithelial carcinoma in uterine serous carcinoma
Abstract
Purpose: To investigate the clinical-pathological findings, prognosis, and survival outcome of uterine serous carcinoma (USC) with or without serous endometrial intraepithelial carcinoma (SEIC) which is still a rare entity in literature.
Materials and Methods: A total of 98 patients with USC who underwent at least a hysterectomy were reviewed. After elimination for exclusion criteria, totally 76 patients with USC who had surgical staging were evaluated. SEIC was defined as the replacement of the surface and glands of the adjacent atrophic endometrium without invasion of the stroma by the highly atypical cells resembling invasive high-grade endometrial carcinoma. The period from surgery to death or last visit was defined as overall survival (OS).
Results: The presence of SEIC was observed in half (n:38). Patients who had USC with SEIC were older and had a higher polypoid pattern than those without SEIC. The 5-year overall survival (OS) was 44.8% and 62.4% in patients with and without SEIC, respectively. There was no statistical significance for other clinicopathological factors in patients who had USC with or without SEIC. The advanced stage was related to a statistically significant hazard ratio for death of 2.45. Furthermore, the stage was found as the only independent factor of OS for USC. And, lymphovascular space involvement was determined as the only independent prognostic factor for OS in patients that had USC with SEIC.
Conclusion: Although the presence of polypoid pattern was significantly higher in patients who had USC including SEIC, it was not associated with survival independently. The stage was the only prognostic factor related to OS for USC. However, the presence of the SEIC had no prognostic effect on the survival of USC.
Keywords
Serous adenocarcinoma , serous intraepithelial neoplasia , uterus , survival
Kaynakça
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al. Global cancer statistics 2020: CA Cancer J Clin. 2021;71:209-49.
- Moore KN, Fader AN. Uterine papillary serous carcinoma. Clin Obstet Gynecol. 2011;54:278-91.
- Hamilton C, Cheung M, Osann K, Chen L, Teng N, Longacre T et al. Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94:642-6.
- DeLair DF, Burke KA, Selenica P, Lim RS, Scott SN, Middha S et al. The genetic landscape of endometrial clear cell carcinomas. J Pathol. 2017;243:230-41.
- Lax SF. Pathology of endometrial carcinoma. Adv Exp Med Biol. 2017;943:75-96.
- Gehrig PA, Groben PA, Fowler WC, Jr., Walton LA, Van Le L. Noninvasive papillary serous carcinoma of the endometrium. Obstet Gynecol. 2001;97:153-7.
- Goff BA, Kato D, Schmidt RA, Ek M, Ferry JA, Muntz HG et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecol Oncol. 1994;54:264-8.
- Hou JY, McAndrew TC, Goldberg GL, Whitney K, Shahabi S. A clinical and pathologic comparison between stage-matched endometrial intraepithelial carcinoma and uterine serous carcinoma: is there a difference? Reprod Sci. 2014;21:532-7.
- Soslow RA, Pirog E, Isacson C. Endometrial intraepithelial carcinoma with associated peritoneal carcinomatosis. Am J Surg Pathol. 2000;24:726-32.
- Hedley C, Sriraksa R, Showeil R, Van Noorden S, El-Bahrawy M. The frequency and significance of WT-1 expression in serous endometrial carcinoma. Hum Pathol. 2014;45:1879-84.
