Prognosis of papillary serous, clear cell, and grade 3 stage I carcinoma of the endometrium.
OBJECTIVE
The purpose of this study was to evaluate patients with uterine papillary serous carcinoma (UPSC), clear cell (CC), and grade 3 endometrioid (G3) surgically stage I endometrial cancer.


METHODS
The 25th Annual Report (AR) of FIGO was used to identify patients with endometrial cancers who were surgically staged. For comparison, all cancers reported were evaluated with particular interest in patients with stage I UPSC, CC, and G3. Incidence, substage, post-surgical treatment, and survival were identified.


RESULTS
Of 5694 endometrial cancer patients reported to the AR, 3996 (70%) were surgically stage I. There were 148 UPSC, 59 CC, and 325 with G3 lesions. UPSC and CC represent 5.2% of all stage I cancers while 8.1% are G3. Although there were greater number of UPSC, CC, and G3 with extrauterine disease, about 50% of UPSC and CC were stage I. This compares to 81% for G1, 68% for G2, and only 42% for G3. There were more IA cancers with UPSC and CC than G3 (22%, 33%, and 17%, respectively). Survival (5 years) for UPSC and CC was 72% and 81%, respectively, compared to 76% for G3 lesions. Postoperative radiation improved survival somewhat (6-8%) but the difference was not significant.


CONCLUSIONS
UPSC and CC histotypes when diagnosed as stage I have a better survival than commonly perceived and equal to G3 endometrioid cancers. Postoperative radiation improves survival but not significantly so. The role of chemotherapy has not been defined.
Creasman
William T
WT
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA. creasman@musc.edu
Kohler
Matthew F
MF
Odicino
Franco
F
Maisonneuve
Patrick
P
Boyle
Peter
P
D000230:Adenocarcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018283:Cystadenocarcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate