title: Mucinous adenocarcinoma of the endometrium: case series and review of the literature.
abstract: OBJECTIVE
  Mucinous carcinoma of the endometrium (MCE) is a rare histologic type representing less than 5% of all endometrial carcinomas. The aim of the study was to describe our experience with MCE and determine its clinical outcome.
  
  
  METHODS
  After institutional review board approval, we performed a comprehensive retrospective review of medical records of patients with uterine adenocarcinoma who underwent surgical staging for MCE in 2 large academic centers between 1990 and 2009. Patients with 2009 International Federation of Gynecology and Obstetrics stages I to III were included. Patients' demographics and tumor characteristics were obtained and analyzed, including data on follow-up and survival.
  
  
  RESULTS
  Thirty-one patients with MCE were identified for the study. Median age was 62 years (range, 43-91 years). All patients underwent surgical staging with lymph node evaluation. Patients' distribution by stage was as follows: 83.9% (n = 26) stage IA, 6.5% (n = 2) stage IIIA, and 9.7% (n = 3) stage IIIC1. Median follow-up was 62 months (range, 1-189 months). Only 30 patients received adjuvant platinum-based chemotherapy. No patients received adjuvant radiation treatment after hysterectomy. Only 4 patients had tumor recurrences with a median time to recurrence of 13.5 months (range, 8-30 months). Three patients with stage IIIC1 and one patient with stage IIIA had a diagnosis of pelvic recurrences. On univariate analysis, factors associated with recurrence were advanced stage (P ≤ 0.0001), deep myometrial invasion (P = 0.0199), lower uterine segment involvement (P = 0.0038), and grade II disease (P = 0.0013). Five-year relapse-free survival was 86.3%, and 5-year overall survival was 81.2%.
  
  
  CONCLUSIONS
  Based on our study cohort, the outcome of patients with FIGO stage I to stage II MCE is excellent with surgical staging alone. However, patients with advanced stages may potentially benefit from adjuvant therapies. These findings need to be validated with other similar studies.
authors.affiliation: Division of Gynecologic Oncology, Department of Women's Health Services, Henry Ford Health System, Detroit, MI 48202, USA.
authors.forename: Randa J
authors.initials: RJ
authors.lastname: Jalloul
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Elshaikh
authors.forename: Rouba
authors.initials: R
authors.lastname: Ali-Fehmi
authors.forename: Michael M
authors.initials: MM
authors.lastname: Haley
authors.forename: Jiyoon
authors.initials: J
authors.lastname: Yoon
authors.forename: Meridith
authors.initials: M
authors.lastname: Mahan
authors.forename: Adnan R
authors.initials: AR
authors.lastname: Munkarah
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*