title: Poor prognosis of uterine serous carcinoma compared with grade 3 endometrioid carcinoma in early stage patients.
abstract: Difference in prognosis between grade 3 endometrioid carcinoma (G3EC) of the endometrium and uterine serous carcinoma (USC) is controversial. In this study, we further evaluated the difference in prognosis, if any, between G3EC (n = 61) and USC (n = 47) on a total of 565 patients with endometrial cancer. In addition, meta-analysis was performed using data from seven previous publications (n = 8,637) and from the Asan Medical Center (n = 108). Regarding the cases from our institution, USC tended to occur in older patients (≥65 years) than G3EC (P = 0.011). Deep myometrial invasion (more than or equal to half) was more frequently identified in G3EC (36/61, 59.0 %) than in USC (17/47, 36.2 %) (P = 0.021). Between patients with early stage G3EC and USC (stages I and II), there were no significant differences in any clinicopathological parameter, but there was a significant difference in overall survival (P = 0.017) that was not found in advanced stage (P = 0.588). USC was an independent prognostic factor for poor overall survival (hazard ratio, 6.125; P = 0.030) in early stage patients. In the meta-analysis on 5-year survival in patients with early stage cancers, which also included our study results, a higher relative risk (1.92, 95 % CI 1.62-2.27) was demonstrated in USC than in G3EC (P < 0.001). In conclusion, our study reveals that USC is associated with a poorer prognosis compared with G3EC, only in patients with early stage carcinoma, suggesting that different treatment strategies should be considered according to the histologic type in order to improve treatment outcome.
authors: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Ji Young
authors: JY
authors: Park
authors: Joo-Hyun
authors: JH
authors: Nam
authors: Young-Tak
authors: YT
authors: Kim
authors: Yong-Man
authors: YM
authors: Kim
authors: Jong-Hyeok
authors: JH
authors: Kim
authors: Dae-Yeon
authors: DY
authors: Kim
authors: Insuk
authors: I
authors: Sohn
authors: Shin-Wha
authors: SW
authors: Lee
authors: Chang Ohk
authors: CO
authors: Sung
authors: Kyu-Rae
authors: KR
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000401:mortality* / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000401:mortality* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D014594:Uterine Neoplasms / Q000401:mortality* / Q000473:pathology; D055815:Young Adult