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Evaluation of clinical and pathological features of mixed endometrial carcinoma in a tertiary medical center

Year 2021, , 395 - 400, 31.03.2021
https://doi.org/10.17826/cumj.866381

Abstract

Purpose: 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. Clinic-pathologic 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.

References

  • 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30.
  • 2. Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up. Int J Gynecol Cancer. 2016;26(1):2-30.
  • 3. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10-7.
  • 4. Murali R, Soslow RA, Weigelt B. Classification of endometrial carcinoma: more than two types. Lancet Oncol. 2014;15(7):e268-78.
  • 5. Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67-73.
  • 6. Talhouk A, McConechy MK, Leung S, Yang W, Lum A, Senz J, et al. Confirmation of ProMisE: A simple, genomics-based clinical classifier for endometrial cancer. Cancer. 2017;123(5):802-13.
  • 7. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366(9484):491-505.
  • 8. de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(3):295-309.
  • 9. Carcangiu M, Kurman RJ, Carcangiu ML, Herrington CS. WHO classification of tumours of female reproductive organs: International Agency for Research on Cancer; 2014.
  • 10. Köbel M, Meng B, Hoang LN, Almadani N, Li X, Soslow RA, et al. Molecular Analysis of Mixed Endometrial Carcinomas Shows Clonality in Most Cases. Am J Surg Pathol. 2016;40(2):166-80.
  • 11. Matrai C, Motanagh S, Mirabelli S, Ma L, He B, Chapman-Davis E, et al. Molecular Profiles of Mixed Endometrial Carcinoma. Am J Surg Pathol. 2020;44(8):1104-11.
  • 12. Hoang LN, Kinloch MA, Leo JM, Grondin K, Lee CH, Ewanowich C, et al. Interobserver Agreement in Endometrial Carcinoma Histotype Diagnosis Varies Depending on The Cancer Genome Atlas (TCGA)-based Molecular Subgroup. Am J Surg Pathol. 2017;41(2):245-52.
  • 13. Li W, Li L, Wu M, Lang J, Bi Y. The Prognosis of Stage IA Mixed Endometrial Carcinoma. Am J Clin Pathol. 2019;152(5):616-24.
  • 14. Roelofsen T, van Ham MA, Wiersma van Tilburg JM, Zomer SF, Bol M, Massuger LF, et al. Pure compared with mixed serous endometrial carcinoma: two different entities? Obstet Gynecol. 2012;120(6):1371-81.
  • 15. Lawrenson K, Pakzamir E, Liu B, Lee JM, Delgado MK, Duncan K, et al. Molecular Analysis of Mixed Endometrioid and Serous Adenocarcinoma of the Endometrium. PLoS One. 2015;10(7):e0130909.
  • 16. Lax SF. Molecular genetic changes in epithelial, stromal and mixed neoplasms of the endometrium. Pathology. 2007;39(1):46-54.
  • 17. Quddus MR, Sung CJ, Zhang C, Lawrence WD. Minor serous and clear cell components adversely affect prognosis in ''mixed-type'' endometrial carcinomas: a clinicopathologic study of 36 stage-I cases. Reprod Sci. 2010;17(7):673-8.
  • 18. Sholl AB, Aisner DL, Behbakht K, Post MD. Novel TP53 gene mutation and correlation with p53 immunohistochemistry in a mixed epithelial carcinoma of the endometrium. Gynecol Oncol Case Rep. 2012;3:11-3.
  • 19. Taşkin EA, Taşkin S, Berker B, Erol E, Dünder I, Söylemez F. Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome. Arch Gynecol Obstet. 2008;277(1):71-3.
  • 20. Rossi ED, Bizzarro T, Monterossi G, Inzani F, Fanfani F, Scambia G, et al. Clinicopathological analysis of mixed endometrial carcinomas: clinical relevance of different neoplastic components. Hum Pathol. 2017;62:99-107.
  • 21. Coenegrachts L, Garcia-Dios DA, Depreeuw J, Santacana M, Gatius S, Zikan M, et al. Mutation profile and clinical outcome of mixed endometrioid-serous endometrial carcinomas are different from that of pure endometrioid or serous carcinomas. Virchows Arch. 2015;466(4):415-22.
  • 22. Matrai CE, Pirog EC, Ellenson LH. Despite Diagnostic Morphology, Many Mixed Endometrial Carcinomas Show Unexpected Immunohistochemical Staining Patterns. Int J Gynecol Pathol. 2018;37(5):405-13.
  • 23. Köbel M, Tessier-Cloutier B, Leo J, Hoang LN, Gilks CB, Soslow RA, et al. Frequent Mismatch Repair Protein Deficiency in Mixed Endometrioid and Clear Cell Carcinoma of the Endometrium. Int J Gynecol Pathol. 2017;36(6):555-61.

Miks endometriyal karsinomun klinik ve patolojik özelliklerinin tersiyer bir merkezde değerlendirilmesi

Year 2021, , 395 - 400, 31.03.2021
https://doi.org/10.17826/cumj.866381

Abstract

Amaç: Bu çalışmada miks endometrial karsinomun (MEK) klinik ve patolojik özelliklerini değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ocak 2000 - Aralık 2019 tarihleri arasında kliniğimizde ameliyat edilen ve düzenli takip edilen 29 MEK hastasının klinik ve patolojik kayıtları gözden geçirildi. MEK grubundaki (n = 29) klinik-patolojik özellikler ve sağkalım, saf seröz (n = 42) ve saf berrak hücreli adenokarsinomlar (n = 13) ile karşılaştırıldı. Hastaların klinik bulguları, operasyon özellikleri, patolojik bulguları, miyometriyal invazyon derecesi (MI), lenf nodu tutulumu (LNI), lenfovasküler alan invazyonu (LVSI), adjuvan tedaviler ve takip verileri ve sağkalıma etkileri araştırıldı.
Bulgular: Olguların 18'inde endometrioid + seröz, 7'sinde endometrioid + berrak hücreli, 3'ünde endometrioid + seröz ve 1'inde berrak hücreli+ seröz histopatoloji vardı. Hastaların ortalama yaşı 63,2 ± 12,1 yıldı. Mikst gruptaki olguların 8'ine (% 27,6) laparoskopik cerrahi uygulandı. Evre, LVSI, LNI, MI ≥% 50 ve omental metastaz oranları gruplar arasında benzerdi. Adjuvan tedavi alma oranları için gruplar arasında önemli bir fark yoktu. Genel olarak hayatta kalma süresi gruplar arasında benzerdi.
Sonuç: MEK'ler, teşhis edilmesi ve yönetilmesi zor olabilen tümörlerdir. Klinikopatolojik özellikler ve prognoz açısından MEK ile saf seröz karsinom ve saf berrak hücreli karsinom arasında fark yoktu. Histopatolojik özelliklerinin yanı sıra moleküler özelliklerinin ortaya çıkarılması ve değerlendirilmesi bu grup tümörleri daha iyi anlamamıza yardımcı olacaktır.

References

  • 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30.
  • 2. Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up. Int J Gynecol Cancer. 2016;26(1):2-30.
  • 3. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10-7.
  • 4. Murali R, Soslow RA, Weigelt B. Classification of endometrial carcinoma: more than two types. Lancet Oncol. 2014;15(7):e268-78.
  • 5. Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67-73.
  • 6. Talhouk A, McConechy MK, Leung S, Yang W, Lum A, Senz J, et al. Confirmation of ProMisE: A simple, genomics-based clinical classifier for endometrial cancer. Cancer. 2017;123(5):802-13.
  • 7. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366(9484):491-505.
  • 8. de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, et al. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2018;19(3):295-309.
  • 9. Carcangiu M, Kurman RJ, Carcangiu ML, Herrington CS. WHO classification of tumours of female reproductive organs: International Agency for Research on Cancer; 2014.
  • 10. Köbel M, Meng B, Hoang LN, Almadani N, Li X, Soslow RA, et al. Molecular Analysis of Mixed Endometrial Carcinomas Shows Clonality in Most Cases. Am J Surg Pathol. 2016;40(2):166-80.
  • 11. Matrai C, Motanagh S, Mirabelli S, Ma L, He B, Chapman-Davis E, et al. Molecular Profiles of Mixed Endometrial Carcinoma. Am J Surg Pathol. 2020;44(8):1104-11.
  • 12. Hoang LN, Kinloch MA, Leo JM, Grondin K, Lee CH, Ewanowich C, et al. Interobserver Agreement in Endometrial Carcinoma Histotype Diagnosis Varies Depending on The Cancer Genome Atlas (TCGA)-based Molecular Subgroup. Am J Surg Pathol. 2017;41(2):245-52.
  • 13. Li W, Li L, Wu M, Lang J, Bi Y. The Prognosis of Stage IA Mixed Endometrial Carcinoma. Am J Clin Pathol. 2019;152(5):616-24.
  • 14. Roelofsen T, van Ham MA, Wiersma van Tilburg JM, Zomer SF, Bol M, Massuger LF, et al. Pure compared with mixed serous endometrial carcinoma: two different entities? Obstet Gynecol. 2012;120(6):1371-81.
  • 15. Lawrenson K, Pakzamir E, Liu B, Lee JM, Delgado MK, Duncan K, et al. Molecular Analysis of Mixed Endometrioid and Serous Adenocarcinoma of the Endometrium. PLoS One. 2015;10(7):e0130909.
  • 16. Lax SF. Molecular genetic changes in epithelial, stromal and mixed neoplasms of the endometrium. Pathology. 2007;39(1):46-54.
  • 17. Quddus MR, Sung CJ, Zhang C, Lawrence WD. Minor serous and clear cell components adversely affect prognosis in ''mixed-type'' endometrial carcinomas: a clinicopathologic study of 36 stage-I cases. Reprod Sci. 2010;17(7):673-8.
  • 18. Sholl AB, Aisner DL, Behbakht K, Post MD. Novel TP53 gene mutation and correlation with p53 immunohistochemistry in a mixed epithelial carcinoma of the endometrium. Gynecol Oncol Case Rep. 2012;3:11-3.
  • 19. Taşkin EA, Taşkin S, Berker B, Erol E, Dünder I, Söylemez F. Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome. Arch Gynecol Obstet. 2008;277(1):71-3.
  • 20. Rossi ED, Bizzarro T, Monterossi G, Inzani F, Fanfani F, Scambia G, et al. Clinicopathological analysis of mixed endometrial carcinomas: clinical relevance of different neoplastic components. Hum Pathol. 2017;62:99-107.
  • 21. Coenegrachts L, Garcia-Dios DA, Depreeuw J, Santacana M, Gatius S, Zikan M, et al. Mutation profile and clinical outcome of mixed endometrioid-serous endometrial carcinomas are different from that of pure endometrioid or serous carcinomas. Virchows Arch. 2015;466(4):415-22.
  • 22. Matrai CE, Pirog EC, Ellenson LH. Despite Diagnostic Morphology, Many Mixed Endometrial Carcinomas Show Unexpected Immunohistochemical Staining Patterns. Int J Gynecol Pathol. 2018;37(5):405-13.
  • 23. Köbel M, Tessier-Cloutier B, Leo J, Hoang LN, Gilks CB, Soslow RA, et al. Frequent Mismatch Repair Protein Deficiency in Mixed Endometrioid and Clear Cell Carcinoma of the Endometrium. Int J Gynecol Pathol. 2017;36(6):555-61.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research
Authors

Mete Sucu 0000-0002-6889-7147

Ömer Geçkil 0000-0002-8368-6153

Çiğdem Akcabay 0000-0003-2068-7412

Ghanim Khatib 0000-0002-0163-1141

Ümran Küçükgöz Güleç 0000-0003-3094-1381

Ahmet Barış Güzel 0000-0002-9498-7592

Mehmet Ali Vardar 0000-0003-0616-6733

Publication Date March 31, 2021
Acceptance Date February 12, 2021
Published in Issue Year 2021

Cite

MLA Sucu, Mete et al. “Miks Endometriyal Karsinomun Klinik Ve Patolojik özelliklerinin Tersiyer Bir Merkezde değerlendirilmesi”. Cukurova Medical Journal, vol. 46, no. 1, 2021, pp. 395-00, doi:10.17826/cumj.866381.