title: Comparable outcome between endometrioid and non-endometrioid tumors in patients with early-stage high-grade endometrial cancer.
abstract: BACKGROUND
  Approximately 25% of endometrial cancer patients present with high-grade tumors. Unlike the clearly defined work-up for non-endometrioid endometrial cancer, no consensus exists for surgical staging and adjuvant therapy in high-grade endometrioid endometrial cancer. We compared the recurrence rate and disease-related mortality (DRM) after treatment between endometrioid and non-endometrioid endometrial cancer.
  
  
  METHODS
  A total of 123 patients diagnosed with early-stage high-grade endometrial cancer at the Dutch Comprehensive Cancer Centre South (CCCS) between January 2005 and December 2011 were included. All patients underwent abdominal hysterectomy and bilateral salpingo-oophorectomy. Patient and tumor characteristics, primary and adjuvant treatment, and outcome were analyzed.
  
  
  RESULTS
  After a median follow-up of 27.9 months, 27.6% (n = 34) of patients had recurrent disease. Distant recurrence rate was equal among endometrioid (14.5%), papillary serous (14.8%), and clear cell (15.4%) types. The total DRM was 15.4% (n = 19). The 5 year recurrence-free survival was not significantly different between early-stage high-grade endometrioid versus non-endometrioid endometrial cancer (P = 0.72).
  
  
  CONCLUSIONS
  Distant recurrence and DRM was high in patients with endometrial cancer regardless of histological type, suggesting the need for different therapies in early-stage high-grade non-endometrioid and endometrioid tumors.
authors.affiliation: Division of Woman and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: E A E M
authors.initials: EA
authors.lastname: Reynaers
authors.forename: N P M
authors.initials: NP
authors.lastname: Ezendam
authors.forename: J M A
authors.initials: JM
authors.lastname: Pijnenborg
mesh_terms: D018269:Carcinoma, Endometrioid / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D018283:Cystadenocarcinoma, Papillary / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D010052:Ovariectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D058994:Salpingectomy
keywords: endometrial cancer; high grade; high risk; recurrence; survival