br Current Problems in Cancer br journal
Current Problems in Cancer
journal homepage: www.elsevier.com/locate/cpcancer
Comparison of clinicopathologic and survival characteristics of high grade endometrial cancers; single center experience
Ozlem Ercelep a,∗, Mahmut Gumus b
a Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey b Department of Medical Oncology, Faculty of Medicine, Bezmi Alem Vakif University, Istanbul, Turkey
Grade 3 Endometrioid Carcinoma Uterine Serous Carcinoma Clear Cell Carcinoma Nonendometrioid Carcinoma
✩ Conflicts of interest: None.
Purpose: Approximately a quarter of endometrial cancers are of high grade. We aimed to perform clinicopathologic and survival evaluation of high grade endometrial cancer in our study.
Method: We evaluated the data of 78 high grade patients; 30 G3EC (Grade 3 Endometrioid Carcinoma), 48 nonendometri-oid carcinomas; 32 USC (uterine serous carcinoma), 16 CCC (clear cell carcinoma), from 312 patients who ML-210 were followed with endometrial cancer between years 2006 and 2016.
Results: Mean age was 62 years (range 43-83) in all pa-tients, the age in histologic subtypes was 56.5, 65, 66.3, years for G3EC, USC, and CCC, respectively. The G3EC mean age is significantly smaller than other histologic subtypes (P = 0.00). The median follow-up time was 39 months (range 6-136). The 5-year overall survival was 55%, 44%, G3EC, and nonendometrioid carcinoma (USC and CCC), respectively (P = 0.127). In the univariate model; age > 65, ECOG-PS ≥ 2, stage 3-4 disease, LVI presence were poor prognostic factors (P < 0.05). Effect of the stage of the disease, the age of the patients and ECOG-PS on survival was demonstrated with multivariate analysis. The clinicopathologic features of the patients were similar.
✩✩ Ethical statement: Not applicable because the study was retrospective. ∗ Correspondence to: Department of Medical Oncology, Pendik Education and Research Hospital, Marmara University, Istanbul, Turkey.
E-mail address: [email protected] (O. Ercelep).
Conclusion: G3EC is seen at a younger age than other high grade endometrial carcinomas. Grade 3 endometrioid carci-nomas have an increasing trend in survival compared to high grade nonendometrioid carcinomas.
Endometrial cancer is the most common gynecologic cancer in developed countries and is the second most common in developing countries. Its incidence is increasing; in 2012, around 320,000 new cases of endometrial cancer were diagnosed worldwide, which is associated with a mortality rate of approximately 20%. Endometrial cancer contains a large number of diseases with different genetic and molecular characteristics.1,2
In the past 30 years, endometrial cancers have roughly divided into 2 subtypes according to their histologic characteristics, hormone receptor expression and grade.3
The most common subtype is type I endometrial cancers which include good and moder-ately differentiated endometrioid endometrial cancers. Clinicopathologic features and molecular profile differ from type II cancer.4-9
Type II endometrial cancers contain non-endometrioid (serous, clear cell carcinoma), high grade, TP53 mutated, hormone receptor negative cancers. It is associated with a higher risk of metastasis and a poor prognosis.3
G3EC contains genomic and epigenomic alterations of both histologic subtypes.12,13 The clin-ical behavior of Grade 3 EC and type II cancers is similar and often coexists. Hence there has been debate about the classification of G3EC as type I or type II EC.10-15 Comparative clinical analyses of G3EC, uterine serous carcinoma (USC), and clear cell carci-noma (CCC) are very limited, due to the low prevalence of these histologic subtypes. The aim of our study was to compare the outcomes between patients with G3EEC and nonendometrioid carcinomas (USC and CC).