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. Conclusion: The identification of SC using the ovarian two-tiered grading system could be an accurate predictor of recurrence in stage IA EG1.

Serous component is a recurrence predictive factor of grade 1 endometrioid carcinoma at stage IA: A multi-institutional and retrospective study

“…Our past report also showed a component in all grades of endometrioid carcinoma resembling ovarian seromucinous carcinoma, which could have an influence on the prognosis [11]. Thus, we considered SC and seromucinous components were useful predictive factors for recurrence or prognosis.…”

“…Serous and seromucinous components were identified from hematoxylin and eosin slides through central pathological review according to previous reports [11,12]. Briefly, serous carcinoma (SC) which comprised less than 5% of the total volume of endometrioid carcinoma, was defined as either high-grade serous carcinoma (HGSC) or low-grade serous carcinoma (LGSC) [10].…”

Zone Formation of Lymphocyte Infiltration at the Invasive Front Results in the Prolonged Survival of Individuals With Endometrial Serous Carcinoma and Endometrioid Carcinoma With Serous Component

“…Cases with serous carcinoma and mixed carcinoma consisting of endometrioid carcinoma and serous carcinoma of any grade using the 2014 WHO criteria were included in our study. In addition, cases of endometrioid carcinoma with serous carcinoma, which comprised less than 5% of the total incidence of serous carcinoma defined by a previous report (7), were included our study. The exclusion criteria were as follows: Other histology (clear-cell carcinoma and carcinosarcoma), cases complicated with other carcinomas (ovarian carcinoma), and lack of cancer in the surgical specimen.…”

“…Patients in which USC comprised at least 5% of the total volume in endometrioid carcinoma cases had the same prognosis as those with pure-type USC (5,6). In addition, less than 5% of USC in the total volume of endometrioid carcinoma was a risk factor of recurrence (7). Therefore, the presence of even small foci of serous carcinoma in endometrioid carcinoma results in a worse prognosis.…”