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[906] Endometrial Endometrioid Adenocarcinoma (EEA): A Pathological Analysis of 827 Consecutive Cases
Z Ghorab, S Nofech-Mozes, N Ismiil, I Ackerman, G Thomas, A Covens, MA Khalifa. University of Toronto, Toronto, ON, Canada
Background: Histopathologic features of EEA have not been comprehensively reviewed in the past two decades. The aim of this study is to update the prevalence of the tumor
s pathologic features with special emphasis on the association between its grade and other prognosticators.
Design: In a population-based study we assessed the various clinical and pathological features of 827 patients with pure EEA accessioned in our department (July 1999 
June 2004). All patients were treated with hysterectomy. Tumor grade was reported in a 2-tiered system, with a 
high grade
defined as having > 50% solid areas. Grade, pathological stage, depth of myometrial invasion, presence of cervical involvement, lymphovascular invasion (LVI) and lymph node status were evaluated.
Results: The median age at diagnosis was 62 years (range 30-94). Forty-three patients were premenopausal. In 85 patients, lymph nodes were sampled. The tumor was low grade in 733 patients (88.6%) and high grade in 94 (11.4%). Tumor pathologic stage distribution was as follows: IA,149 (18%); IB, 343 (41.5%); IC, 151 (18.2%); IIA, 55 (6.6); IIB, 82 (9.9%); III, 42 (50.8%); and stage IV, 5 (0.6%) cases. The tumor was confined to the endometrium in 154 (18.6%) cases, invaded into the inner myometrial half in 424 (51.3%) cases and the outer half in 249 (30.1%) cases. Cervical involvement was observed in 171 (20.7%) patients and LVI was noted in 182 (22%) cases. The associations between tumor grade and depth of myometrial invasion, cervical involvement and LVI are shown in Table 1. Lymph nodes were sampled in 85 patients. Lymph node metastases were observed in 13 (1.6%) cases and ovarian metastases in 15 cases (1.8%). Chi-square test showed that high tumor grade was significantly associated with deep myometrial invasion (p<0.0001), cervical involvement (p=0.0065) and LVI (p<0.0001).
Conclusions: Endometrial endometrioid adenocarcinoma presents most commonly with a low histologic grade. In approximately 70% of the patients, the tumor does not invade into the outer half of the myometrium. High tumor grade is significantly associated with deep myometrial invasion, cervical involvement and LVI.
| Variable | Low Grade (n=733) | High Grade (n=94) |
| Myometrial Invasion | ||
|---|---|---|
| Absent | 152 | 2 |
| Inner half | 387 | 37 |
| Outer half | 194 | 55 |
| Cervical involvement | ||
| Glandular | 60 | 9 |
| Stromal | 81 | 21 |
| Lymphovascular involvement | 131 | 51 |
Category: Gynecologic
Monday, March 26, 2007 8:00 AM
Platform Session: Section C, Monday Morning