Comparison of clinicopathological and survival analysis of uterus confined carcinosarcoma and grade 3 endometrioid endometrium cancer

Yıl 2021, , 7 - 11, 28.03.2021

Caner Çakır , Vakkas Korkmaz , Çiğdem Kılıç , Dilek Yüksel , Mehmet Ünsal , Betül Tokgöz , Fatih Kılıç , Sevgi Koç , Fulya Kayıkçıoğlu , Taner Turan

https://doi.org/10.46969/ezh.753136

Öz

Aim: Although Grade 3 endometrioid endometrial cancer (G3ECC) and carcinosarcomas (CS) are included in the same risk group among endometrial cancer cases in the consensus published by ESMO-ESGO-ESRTO in 2015, the biological behaviors of these histological types are different. In this study, we aimed to compare grade 3 endometrioid endometrial cancer cases with carcinosarcoma cases limited to the uterus in terms of clinical results and survival analysis.
Material and Methods: Grade 3 endometrioid endometrial cancer (G3 ECC) cases (n = 67) in which the disease is limited to the uterus and uterine limited CS cases (n = 54) were compared in terms of clinical results and survival analysis.
Results: Despite the limited disease in the uterus, survival was significantly worse in patients with carcinosarcoma. While recurrence was 10.5% in G3ECC, this rate was found as 27.8% in CS (p = 0.011).
Conclusion: Carcinosarcomas may have a worse prognosis than G3 endometrioid endometrial cancers even in the early stages.

Anahtar Kelimeler

Endometrioid endometrium cancer, Grade 3, carcinosarcoma, high risk, endometrial cancer, recurrence

Uterusa sınırlı karsinosarkom ve grade 3 endometrioid endometrium kanserinin klinikopatolojik ve sağkalım analizlerinin karşılaştırılması

Öz

Amaç: Grade 3 endometrioid endometrium kanseri (G3ECC) ve karsinosarkom (KS), ESMO-ESGO-ESRTO’un 2015’de yayınladığı konsensüsunda endometrium kanseri olguları içinde aynı risk grubunda yer alsa da, bu histolojik tiplerin biyolojik davranışları farklıdır. Bu çalışmada G3ECC olguları ile uterusa sınırlı KS vakalarının klinik sonuçlar ve sağkalım analizleri açısından karşılaştırılması amaçlandı.

Gereç ve Yöntem: Uterusa sınırlı hastalığı olan G3ECC olguları (n=67) ile uterusa sınırlı karsinosarkom (KS) olguları (n=54) klinik sonuçları ve sağkalım analizleri açısından karşılaştırıldı.

Bulgular: Uterusa sınırlı hastalık olmasına rağmen KS olan hastalarda sağkalımın belirgin kötü olduğu görüldü. Rekürrens G3ECC’de %10,5 iken, KS’da bu oran %27,8 olarak saptandı (p=0,011). 

Sonuç: Karsinosarkomlar erken evrede dahi G3 endometrioid endometrium kanserlerinden daha kötü prognoza sahip olabilirler. 

Anahtar Kelimeler

Endometrioid endometrium kanseri, grade 3, karsinosarkom, yüksek risk, endometrial kanser, rekürrens

Kaynakça

• Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer 1987; 60(8 Suppl):2035-2041.
• Creutzberg CL. GOG-99: ending the controversy regarding pelvic radiotherapy for endometrial carcinoma? Gynecol Oncol 2004; 92:740-743.
• Mariani A, Dowdy SC, Cliby WA ve ark. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol 2008; 109:11-18.
• Colombo N, Creutzberg C, Amant F ve ark. ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: Diagnosis, treatment and follow-up. Radiother Oncol 2015; 117:559-581.
• Vaidya AP, Horowitz NS, Oliva E, Halpern EF, Duska LR. Uterine malignant mixed mullerian tumors should not be included in studies of endometrial carcinoma. Gynecol Oncol 2006; 103:684–687.
• Creasman W. Revised FIGO staging for carcinoma of the endometrium. Int J Gynaecol Obstet 2009; 105:109.
• Bansal N, Herzog TJ, Seshan VE, et al. Uterine carcinosarcomas and grade 3 endometrioid cancers: evidence for distinct tumor behavior. Obstet Gynecol 2008; 112:64-70.
• Zhang C, Hu W, Jia N et al. Uterine carcinosarcoma and high-risk endometrial carcinomas: a clinicopathological comparison. Int J Gynecol Cancer 201; 25:629-636.
• Prueksaritanond N, Chantape W. Comparative Survival Outcomes of UterinePapillary Serous Carcinoma, Clear Cell Carcinoma, Grade 3 EndometrioidAdenocarcinoma, and Carcinosarcoma of Endometrial Cancer in Rajavithi Hospital. J Med Assoc Thai 2016; 99:S75-83.
• Zhu J, Wen H, Bi R, Wu X. Clinicopathological characteristics, treatment and outcomes in uterine carcinosarcoma and grade 3 endometrial cancer patients: a comparative study. J Gynecol Oncol 2016; 27:e18.