Aggressive stage I grade 1 endometrial carcinoma.
BACKGROUND
Patients with Stage I Grade 1 endometrial carcinoma have an excellent prognosis and a 10-year survival rate of more than 90%. In every clinical series, however, a few patients in this group have recurrence and die of their disease.


METHODS
The authors reviewed 80 patients with Stage I Grade 1 endometrial carcinoma treated at their institution from 1955-1980. Eight patients died of recurrent disease within 4 years of diagnosis. The authors studied multiple clinical and histopathologic features, estrogen receptor (ER) and progesterone receptor (PR) status, DNA flow cytometric characteristics, and the expression of c-myb, H-ras, and neu oncogenes. Results were compared with those for a control group of 11 patients who survived more than 10 years free of disease.


RESULTS
The authors identified the following four statistically significant adverse prognostic factors: myometrial invasion, vascular invasion, 8 or more mitoses per 10 high-power fields, and an absence of PR. Residual tumor, aneuploidy, and high proliferative activity were associated with a more aggressive behavior, although the relationship did not reach statistical significance.


CONCLUSIONS
All patients who died of disease within 4 years had tumors with two or more of the significant adverse prognostic factors.
Tornos
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Departments of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Silva
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EG
el-Naggar
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A
Burke
T W
TW
D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D016889:Endometrial Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000235:genetics / Q000473:pathology; D009367:Neoplasm Staging; D009857:Oncogenes / Q000235:genetics; D016612:Paraffin Embedding; D011379:Prognosis; D012307:Risk Factors