title: Small Foci of Serous Component as a Predictor of Recurrence and Prognosis for Stage IA Endometrial Carcinomas.
abstract: OBJECTIVE
  Most of the endometrial carcinomas are detected in early stages and have a better prognosis; however, predictive factors for recurrence have not been determined.
  
  
  METHODS
  Patients with grade 1 endometrioid carcinoma (EG1) according to the 2014 WHO criteria at FIGO 2009 stage IA that were identified through scanning medical charts were included, and we assessed whether the presence of uterine serous carcinoma (SC) component which comprised less than 5% of the total volume using the ovarian two-tiered grading system could be a recurrent risk factor in these patients.
  
  
  RESULTS
  Among 126 cases which met inclusion criteria, 12 cases had SC. SC tumors were divided into 2 groups: SC resembling high-grade serous carcinoma (HGSC) and SC resembling low-grade serous carcinoma (LGSC). Five (3.9%) cases had HGSC and 7 (5.6%) cases had LGSC. Recurrence was observed in 3 of all cases (2.3%): 2 cases with HGSC, and 1 case with LGSC. Regarding several clinicopathological factors, only the presence of SC was associated with recurrence. The sensitivity and specificity to predict recurrence using this system were 100 and 93%, respectively.
  
  
  CONCLUSIONS
  The identification of SC using the ovarian two-tiered grading system could be an accurate predictor of recurrence in stage IA EG1.
authors.affiliation: Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan.
authors.forename: Morikazu
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Takano
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Soyama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Aoyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Kento
authors.initials: K
authors.lastname: Kato
authors.forename: Hideki
authors.initials: H
authors.lastname: Iwahashi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Matuura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Ayako
authors.initials: A
authors.lastname: Suzuki
authors.forename: Junko
authors.initials: J
authors.lastname: Hirata
authors.forename: Kenichi
authors.initials: K
authors.lastname: Furuya
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D018284:Cystadenocarcinoma, Serous / Q000097:blood / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000097:blood / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: Endometrial cancer; High-grade serous carcinoma; Low-grade serous carcinoma; Recurrence; Two-tier ovarian serous carcinoma grading system